欧洲药学监护联盟分类系统在儿科用药相关问题中的探索和实践

Exploration and Practice of Pharmaceutical Care Network Europe Classification System in Pediatric Medication-Related Issues

目的:探索欧洲药学监护联盟(PCNE)分类系统在儿科用药相关问题中的应用。方法:选取2021年11月-2022年10月在南京医科大学第四附属医院儿科住院治疗的患儿为研究对象,专职临床药师全程参与查房并进行医嘱审核,采用PCNE分类系统(9.1版)评估患儿出现的药物相关问题(DRPs),并对发生DRPs的类型、原因、干预方案、干预方案的接受程度及DRPs状态等进行分析。结果:本研究共纳入1184例患儿,其中专职临床药师发现304例患儿在住院治疗期间存在不同程度的DRPs,总计336例。DRPs类型中与治疗有效性相关的问题175例(52.08%),与治疗安全性相关的问题117例(34.82%);药物剂量过低和药物疗程过长为DRPs发生的主要原因;实际干预292例,干预成功率为86.90%。结论:PCNE分类体系的引入能够提升临床药师发现和解决DRPs的能力,将PCNE分类系统作为契机,建立完善的药学监护系统,精确分析DRPs,促进合理用药,保障对儿童的用药安全。

Objective:To probe into the application of Pharmaceutical Care Network Europe(PCNE)classification system in pediatric medication-related issues.Methods:Children hospitalized in pediatrics of the Fourth Affiliated Hospital of Nanjing Medical University from Nov.2021 to Oct.2022 were selected as the research subjects.Professional clinical pharmacists participated into the ward round and reviewed the medical orders.The PCNE classification system(version 9.1)was used to evaluate the occurrence of drug-related problems(DRPs)in children,and the types,causes,intervention programs,acceptance of intervention programs of DRPs were analyzed.Results:A total of 1,184 children were enrolled,professional clinical pharmacists found 304 children with different degrees of DRPs(336 cases)during hospitalization.There were 175 questions(52.08%)related to treatment efficacy and 117 questions(34.82%)related to treatment safety in the types of DRPs.The main reasons for the occurrence of DRPs were low dosage of drugs and long treatment course in the type of causes.There were 292 actual interventions,with a success rate of 86.90%.Conclusion:Introduction of PCNE classification system can improve the ability of clinical pharmacists to find and solve DRPs,and PCNE classification system can be used as an entry point to establish the perfect pharmaceutical monitoring system,accurately analyze DRPs,promote rational drug use,and ensure the safety of drug use for children.