某院PIVAS抗肿瘤免疫调节用药医嘱分析及干预效果评价

Medical orders analysis and intervention effect evaluation of PIVAS anti-tumor immunomodulatory drugs in a hospital

目的分析静脉药物调配中心(PIVAS)抗肿瘤免疫调节药物医嘱情况,探讨其不合理性和药师对不合理医嘱的干预效果,为临床提供参考。方法对某院PIVAS 2021年10月~2022年10月抗肿瘤免疫调节剂静脉用药的医嘱进行统计,根据药品说明书及相关指南分析不合理医嘱原因与占比、干预医嘱占比,并分析药师干预前、后的变化,整理调配和输注要点。结果某院现有抗肿瘤免疫调节药物品种稳定,其中替雷利珠单抗和卡瑞利珠单抗用药频度较多。不合理医嘱数共54份,其中占比最高的类型为用法用量错误;药师对不合理医嘱的干预成功率达96.3%。结论PIVAS药师对不合理医嘱的干预效果显著,有效降低了抗肿瘤免疫调节药物的不合理应用,同时为该类药物后续标准化管理提供依据。

Objective To analyze the medical orders of anti-tumor immunomodulatory drugs in pharmacy intravenous admixture services(PIVAS)of a hospital,to explore its irrationality and the intervention effect of pharmacists on irrational prescription,so as to provide reference for clinical practice.Methods From October 2021 to October 2022,the medical orders of intravenous anti-tumor immunomodulators in PIVAS of our hospital were statistically analyzed.According to the drug instructions and relevant guidelines,the causes and proportion of unreasonable medical orders and the proportion of intervention medical orders were analyzed,and the changes before and after the pharmacist intervention were analyzed,and the key points of dispensing and infusion were sorted out.Results The variety of anti-tumor immunomodulatory drugs in the hospital is stable,among which tislelizumab and carrelizumab are used more frequently.The number of unreasonable medical orders was 54,of which the highest proportion was wrong usage and dosage.The success rate of pharmacists'intervention on unreasonable medical orders was 96.3%.Conclusion The intervention effect of PIVAS pharmacists on unreasonable medical orders is significant,which effectively reduces the irrational application of anti-tumor immunomodulatory drugs,and provides a basis for the subsequent standardized management of such drugs.