急性冠状动脉综合征住院患者药学监护的实施效果评价  

Implementation pharmaceutical care for in-patients with acute coronary syndromes

作　　者：季闽春[1] 钱庆庆[1] 沈晓英[1] 沈骁亮[2] 乔祺 孙光春[1] 

机构地区：[1]复旦大学附属上海市第五人民医院药剂科,上海200240 [2]复旦大学附属上海市第五人民医院心内科,上海200240

出　　处：《中国临床药学杂志》2016年第4期240-244,共5页Chinese Journal of Clinical Pharmacy

基　　金：上海市闵行区自然科学研究项目(编号2013MHZ041)

摘　　要：目的为急性冠状动脉综合征住院患者提供专业化和标准化的药学服务。方法采用前瞻性研究,临床药师运用标准工作流程,对2013年10月至2015年5月急性冠状动脉综合征住院患者的治疗方案进行评估,制定药学监护计划,干预用药问题,随访治疗结果。结果共214例患者入选,多数患者的治疗方案符合急性冠状动脉综合征的相关指南。发现12例重复用药,61例涉及药物有效性和31例不良反应等问题,我们通过文献资料、讲座等与医师和护士进行了沟通与交流。大多数患者缺乏用药知识,我们对153例(71.5%)患者进行了用药指导,发放编译资料589份,图书150册。对214例患者进行了随访,发现患者静息心率的达标率较低,其次为低密度脂蛋白胆固醇。结论药学监护的实施,有助于优化药物使用,减少用药差错,并增强临床药师与医师、护士、患者之间的沟通与交流。AIM To provide standard and professional pharmaceutical service for in-patients with acute coronary syndromes （ACS）. METHODS A prospective study was performed, the clinical pharmacists established standardized workflow, assessed medical regimens, designed pharmaceutical care plans, intervened and followed up therapy for pa- tients hospitalized from October 2013 to May 2015. RESULTS Of 214 patients studied, most were given best-practice therapy based on the ACS guidelines. The 12 patients＇ medications had therapeutic duplications, 61 and 31 patients＇ prescriptions had efficient and drug safety problems, we discussed with clinical professionals with these problems. The majority of patients had poor understanding about clinical applications of used drugs, we educated 153 （71.5 % ） of them about drug use, dispensed 589 copies of written materials and 150 books about drug knowledge. CONCLUSION Imple- menting pharmaceutical care can not only assist medical staffs in optimal usage of drugs, reduce medication error, but al- so increase the communication among pharmacists , ohvsieians, nurses and oatients.

关 键 词：急性冠脉综合征 药学监护实施 合理用药 

分 类 号：R541.4[医药卫生—心血管疾病]