医疗机构药师干预促进合理用药管理的系统评价  

Pharmacist intervention to promote rational use for drug management in health system:a systematic review

作　　者：张勤[1] 姜云平[1] 郑咏池[2] 陈华[1] 谭永红[1] 蒋燕[1] 金伟华[1] 黄玉普[3] 

机构地区：[1]成都军区总医院药剂科,四川成都610083 [2]都江堰市医疗中心药剂科,四川都江堰611830 [3]四川省第二中医医院,四川成都610015

出　　处：《中国医院药学杂志》2015年第14期1327-1332,共6页Chinese Journal of Hospital Pharmacy

摘　　要：目的:了解药师为规范临床药物治疗行为进行技术合作和技术干预的内容,以及我国开展合理用药工作的现状,为合理用药管理提供决策依据。方法:以干预、药学、药事和药师等检索词建立检索策略,通过文献计量学方法,统计、分析2005-2013年中国医院数字图书馆(CHKD)和万方医学网(Wanfang Med Online)发表的"药师参与合理用药工作管理"的相关文献;统计文献数量,分析汇总期刊分布。结果:检索2005-2013年发表的干预相关文献1 478篇,有效文献991篇,分布于196种杂志,相关论文在期刊中的分布并不均匀,具有明显的集中和离散规律;载文量前10位均为药学期刊,达404篇,载文量占40.77%,期刊占1.00%,显示较高的集中趋势。药师干预随年度逐步增长,干预内容随国家相关法规的颁布、政策的调整、管理工作的安排而变化。药事干预分层制策,因地制宜;干预方法、形式及内容多样,干预对象涉及医、药、护及患者;根据工作内容,干预时机分事前、事中和事后干预;干预地点前移;干预适度;干预质量逐步提高。结论:我国医疗机构药师参与临床实践形式呈多样化,涵盖专科疾病治疗、抗凝门诊、处方管理、药物应用管理、治疗药物评价与分析、静脉输液配置、治疗药物监测、药物不良反应监测、药品临床应用数据分析、药物相关的健康教育及解决与药物有关的问题等专业性实践。临床实践证明,药师干预是规范药物相关医疗行为,促进药物合理使用的一种行之有效的手段之一;干预同时若叠加行政管理,建立规范的干预标准及干预质量评价体系,药师干预的效果会进一步提高。OBJECTIVE To investigate current situation of pharmacist intervention in clinical drug therapy behavior through professional cooperation and to provide basis for development of rational drug use policy.METHODS A retrieval strategy was established by intervention,pharmacist and pharmacy,to review and analyse the published literatures related to rational drug use management which collected in CHKD and Wanfang Med Online in from2005 to 2013.RESULTS A total 1,478 intervention related literatures published from2005 to 2013 were retrieved.Among them,the effective literature amounted to 991 which distributed in 196 journals.Related papers in journals were not distributed uniformly,obviously concentrated and discrete.Top 10 were pharmaceutical journals of 404,accounting for 40.77%.Periodicals proportion was 1.00%,which showed high concentrating trend.At present,pharmacist intervention showed stratification and diversity.The intervention objective included doctors,pharmacists,nurses and patients.According to working content,intervention period was divided into three grades.Intervention quality was also gradually improved.CONCLUSION Pharmacists＇ clinical practice forms are diversified in China,covering disease treatment specialist,anti-coagulation clinic,prescription management,drug use management,evaluation and analysis of therapeutic drugs,PIVAS,therapeutic drug monitoring,drug adverse reaction monitoring,data analysis and health education on drug-related and drug-related issues dealing such as professional practice.Clinical practice has proved that the pharmacist interventions is a feasible measure to regulate drug-related medical care and promote rational use of medicines.Efficacy of intervention can be improved significantly when intervention is combined with administration by competent authority,by establishing regular interventional standards and intervention evaluation system.

关 键 词：药师 药学 干预 合理用药 文献计量学 

分 类 号：R969[医药卫生—药理学]