ObjectiveTo investigate the management methods of drug repercussion and its intervention measures in the Burn and Plastic Surgery Department by analyzing the reasons for drug repercussion. MethodBased on the drug repercussion data provided by the computer information center, we analyzed the common reasons and the status quo of drug repercussion. Active intervention measures were carried out, and real-time supervision and feedback of drug repercussion management were also performed. We compared such repercussion indexes before intervention (between May and September 2013) and after intervention (between October 2013 and February 2014):number of drug repercussion patients, times of drug repercussion, amount of money involved in drug repercussion, ratio of drug repercussion and dispensing and comprehensive ranking of the drug repercussion in the whole hospital. ResultsAfter intervention, the ranking of the causes of drug repercussion changed obviously. Changing orders casually dropped to the 3rd of the rank, and changing the department based on necessity rose from the 4th to the 2nd. All the indexes (including the times, number, and amount of money of drug of repercussion, and the ratio of repercussion and dispensing and compreheasive rank) reduced significantly (P<0.05). ConclusionsActualizing active intervention measures redounds to reducing drug repercussion, standardizing clinical use of drugs, insuring safety, and advancing the satisfaction of patients and quality of medical nursing.
目的 探讨临床药师在支气管哮喘住院患者的药学监护作用。 方法 临床药师在呼吸科参与具体药物治疗的1例支气管哮喘住院患者药学监护过程进行分析总结。 结果 临床药师通过全程的药学监护，及时发现并解决相关药物治疗问题，为临床提供合理建议，加强了患者用药的安全性。 结论 临床药师实施药学监护对患者个体化治疗具有极其重要的意义。
Objective To investigate the role of clinical pharmacists in warfarin therapy. Methods A total of 134 patients underwent prosthetic heart valve replacement and had warfarin for life from March 2013 to October 2013 in Fujian Medical University Union Hospital. All patients were equally divided into two groups (an intervention and a non-intervention group) crosswise by sequence. There were 67 patients in each group. The anticoagulant effects of the two groups were compared. Results There was no statistical difference in the patients' demographic information between the two groups. However, the time for the patients to reach the target international normalized ratio(INR) values for the first time (7.1±3.3 dvs. 10.5±5.0 d,P=0.000) and time of INR in the therapy range (46.3%±18.8%vs.19.0%±16.2%,P=0.000) during their hospitalization, proportion of time of under anticoagulation (47.5%±19.5%vs. 71.2%±22.9%,P=0.000), proportion of time of anticoagulation overdose (5.3%±8.2%vs. 9.9%±16.7%,P=0.002) were significantly different. While there was no statistical difference in postoperative hospitalization time between the two groups (19.9±6.6 dvs. 18.1±7.0 d,P=0.137). There were 4 patients (6.0%) with minor hemorrhage and no severe complication was found in the intervention group. There were seven patients (10.4%) with mild hemorrhage, two patients with stroke, one patient with mild pulmonary embolism, and severe complication rate of 4.5% in the non-intervention group. Conclusion With clinical pharmacists involved in the whole anticoagulation therapy progress of patients after mechanical heart valve replacement, the time to achieve the therapeutic window for the first time is effectively shorten, and the time of the INR value controlled in therapeutic range is highly improved during hospitalization time. Moreover, the patients' risk of thrombosis and bleeding is eventually reduced.
【摘要】 目的 验证临床药师对外科预防使用抗菌药物进行干预的效果。 方法 以临床药师督查记录数据为基础，将2010年1-3月238份病历设为非干预组，2010年10—12月240份病历设为干预组，建立评价标准，进行回顾性汇总、分析。 结果 通过干预，抗菌药物使用率从干预前的100%下降为77.08%（χ2=63.633，P=0.000），抗菌药物联用情况减少（χ2=53.712，P=0.000），用药时机和用药疗程有了较大改善，抗菌药物费用下降（t=-5.235，P=0.000），住院医疗费用降低（t’=-12.280，P=0.000），住院天数减少（t=-5.071，P=0.000）。 结论 临床药师通过实施合理用药干预对促进医院安全、有效、经济使用抗菌药物起到了积极作用。【Abstract】 Objective To verify the effect of clinical pharmacists’ intervention in antibiotics used for Type I incision surgical prevention. Methods Based on the supervision and inspection recording data of clinical pharmacists, we arranged 238 medical records in the first quarter of 2010 as non-intervened group and 240 medical records in the fourth quarter of 2010 as intervened group, and then established evaluation criteria and conducted a retrospective study for analysis. Results Through intervention, the rate of using antibiotics decreased from the previous 100% to 77.08% (χ2=63.633, P=0.000), the use of combined antibiotics also decreased (χ2=53.712, P=0.000), the time of course of using antibiotics improved, medical expenses of the antibiotics were reduced (t=-5.235, P=0.000), hospitalization cost decreased (t=-12.280, P=0.000), and hospital stay was shortened (t=-5.071, P=0.000). Conclusion Clinical pharmacists’ intervention in rational use of drugs play a positive role in contribution to a safe, effective and economical application of antibiotics.
Objective To evaluate the effect of physician-nurse-pharmacist collaboration on cardiovascular disease risk factors in diabetes patients. Methods Randomized controlled trails (RCTs) on collaboration among physicians, nurses and pharmacists for reducing cardiovascular disease risk factors in diabetes patients were collected from Cochrane Central Register of Controlled Trials, Medline (Ovid SP), Embase, China Knowledge Resource Integrated Database, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analysis with the Cochrane Collaboration’s Revman 5.3.0 software. Results Seven RCTs were included. The results of meta-analysis showed that the change in glycosylated hemoglobin A1c, systolic blood pressure, diastolic blood pressure and low density lipoprotein-cholesterol were significantly reduced in the collaboration group than in usual care group [SMD=–0.39, 95%CI (–0.56, –0.21),P<0.000 1;SMD=–0.30, 95%CI (–0.43, –0.18),P<0.000 01;SMD=–0.37, 95%CI (–0.64, –0.11),P=0.006;SMD=–0.11, 95%CI (–0.16, –0.06),P<0.000 1]. Conclusions Collaboration among physicians, nurses and pharmacists is effective for reducing cardiovascular disease risk factors in diabetes patients. But its long-term efficacy still needs to be confirmed by performing higher quality, large sample RCTs with long-term follow-up.
【摘要】 目的 探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）治疗方案及药学监护的内容。 方法 以2007年12月收治的1例COPD患者为例，结合COPD治疗指南，为COPD急性加重期患者制定个体化的药学监护计划并实施全程的药学监护。 结果 患者COPD急性加重期的药物治疗方案有效合理。通过全程的药学监护，及时发现和解决了患者药物治疗的问题，为临床合理用药提供了意见。 结论 对COPD患者实施药学监护具有可行性和实用性。【Abstract】 Objective To investigate the treatment and pharmaceutical care for chronic obstructive pulmonary disease (COPD) patients. Methods In December 2007, a patient with COPD was diagnosed, and based on the clinical data, COPD treatment guidelines were adopted to analyze treatment plans. For patients with acute exacerbation of COPD, individualized pharmaceutical care plan was proposed, and pharmaceutical care was performed during the whole course of disease. Results The drug treatment for the one patient with acute exacerbation of COPD was effective and reasonable. Treatment problems were observed and solved through pharmaceutical care which had given reasonable suggestions for medication. Conclusion The implementation of pharmaceutical care for COPD patients is feasible and practical.
ObjectiveTo explore the role of clinical pharmacists in caring for one patient with breast cancer complicated with multiple metastases. MethodsClinical pharmacists monitored the entire treatment process of a patient with breast cancer complicated with multiple metastases. Blood glucose level was recorded, and the pharmacists evaluated the patient's pain, gave appropriate doses of cancer pain drugs, and responded positively to the hand-foot syndrome (HFS) induced by chemotherapeutic drugs. ResultsWith the participation of the pharmacists, clinicians adjusted the medication. Ideal control of cancer pain and blood glucose was achieved with successful chemotherapy, and HFS fully recovered. ConclusionPharmaceutical care by clinical pharmacists can assist clinicians to ensure the safety and effectiveness of drug use.