摘要
目的通过临床药师对心血管内科患者的用药监护及用药干预,指导患者合理使用药品,降低患者用药风险。方法我院临床药师对心血管内科就诊的1563例患者进行独立药学查房问诊,在对患者进行用药指导及用药教育过程中进行药学监护,包括药物的用法用量、遵医嘱服药情况、药物漏服、药物相互作用、药品保存、注射剂滴速等。采用Morisky评价法评价其用药依从性。结果共照护患者1563例,干预患者539例,干预患者医嘱条目数为647条,其中服用时间错误、漏服药物、不遵医嘱服药、服用方法错误、注射剂滴速不适宜、使用含激素的雾化吸入制剂未漱口、药品保存不当、用药剂量错误、药物存在相互作用、服用频次错误的数量(在总干预医嘱中的比例)依次为474条(73.26%)、84条(12.98%)、29条(4.48%)、18条(2.78%)、16条(2.47%)、11条(1.70%)、5条(0.77%)、4条(0.62%)、4条(0.62%)、2条(0.31%)。临床药师干预后,患者对用药适应证、药物用法用量、特殊药物的保存及不良反应的知晓率分别由19.59%、18.86%、18.54%和8.18%提升至61.31%、64.76%、65.58%和38.76%,患者的用药依从性由原来的70.89%提高到94.50%,差异有统计学意义(P<0.05)。结论临床药师深入临床指导患者用药,全程提供药学监护及用药教育,提高了患者用药依从性,保障了患者的用药安全、有效,体现了临床药师的专业价值。
Objective To guide the rational use of drugs and reduce the risk of medication in patients by clinical pharmacists′monitoring and intervening the drug use of patients in the cardiovascular medical department.Methods Clinical pharmacists of our hospital gave an independent pharmaceutical ward round of consultation to 1563 patients in the cardiovascular medical department,and performed pharmaceutical care in the process of medication guidance and education,including the dosage and usage of drugs,medication according to prescription,missed medication,drug interactions,drug storage and injection rate,etc.The Morisky evaluation method was used to evaluate the medication compliance.Results A total of 1563 patients received the pharmaceutical care and the medication of 539 patients was intervented.The number of medical orders of intervention for patients was 647.There were 474(73.26%),84(12.98%),29(4.48%),18(2.78%),16(2.47%),11(1.70%),5(0.77%),4(0.62%),4(0.62%)and 2(0.31%)items of time error,missed medication,not taking drugs according to the prescription,inappropriate way of taking drugs,inappropriate injection rate,using hormone-contained atomization inhalation preparations without mouthwash,improper storage of drugs,dosage error,drug interaction and inappropriate medication frequency.After intervention of clinical pharmacists,the awareness rate of patients about indications,drug usage and dosage,preservation of special drugs and adverse reactions increased from 19.59%,18.86%,18.54%and 8.18%to 61.31%,64.76%,65.58%and 38.76%,respectively,and the compliance rate of patients increased from 70.89%to 94.50%(P<0.05).Conclusion Clinical pharmacists′in-depth clinical guidance for patients on medication and pharmaceutical care and education in the whole process of medication can improve the medication compliance and ensure the medication safety and effectiveness,and reflects the professional value of clinical pharmacists.
作者
张雪花
宋燕青
王相峰
李艳娇
ZHANG Xue-hua;SONG Yan-qing;WANG Xiang-feng;LI Yan-jiao(Department of Pharmacy,the First Hospital of Jilin University,Changchun 130021,China)
出处
《实用药物与临床》
CAS
2021年第12期1118-1122,共5页
Practical Pharmacy and Clinical Remedies
关键词
临床药师
药学服务
用药依从性
药学监护
Clinical pharmacists
Pharmaceutical service
Medication compliance
Pharmaceutical care
