药师审核干预对促进他汀类药物临床合理用药的实践与探讨  

Practice and discussion to improve the pharmacist intervention skills about rational clinical use of statins

作　　者：樊萍[1] 高洋洋[1] 何璐璐[1] 杨梅梅[1] 徐珽[1] FAN Ping;GAO Yang-yang;HE Lu-lu;YANG Mei-mei;XU Ting(Department of Pharmacy,West China Hospital of Sichuan University,Siehuan Chengdu 610041,China)

机构地区：[1]四川大学华西医院临床药学部,四川成都610041

出　　处：《中国医院药学杂志》2018年第19期2079-2083,共5页Chinese Journal of Hospital Pharmacy

基　　金：四川省卫生厅科研基金(编号:18PJ529;17PJ462)

摘　　要：目的:了解医院门诊药房他汀类血脂调节药物的使用情况,分析处方的用药合理性,针对存在的问题通过加强药师对他汀类药物处方的审核干预,促进他汀类药物临床合理用药,减少不良反应的发生。方法:调取某大型三甲医院门诊药房2016年1-6月与2017年1-6月中关于他汀类药物的电子处方,比较加强药师对他汀类药物审核干预前后,对他汀类药物用药合理性进行统计和分析。结果:通过实施提升药师对他汀类药物的审核干预综合技能的措施后,他汀类药物处方占抽查处方比例(%):处方的不合理率(2.57±0.11 vs.1.47±0.25)、临床诊断与用药不符(0.68±0.16 vs.0.62±0.08)、重复用药(0.33±0.05 vs.0.06±0.02,P<0.01)、用法用量不适宜(0.73±0.21 vs.0.43±0.16)及联合用药不适宜(0.94±0.09 vs.0.37±0.12,P<0.05)等情况均较提升整改前均有所减少;他汀类药物不合理类型占他汀类药物总不合理处方比例(%):重复用药(12.65±1.84 vs.4.16±1.95,P<0.05)及联合用药不适宜(36.75±4.01 vs.24.79±7.06,P<0.05)等情况均较提升整改前均有所减少,而临床诊断与用药不符(26.67±6.61 vs.42.38±3.61)、用法用量不适宜(23.95±4.86 vs.28.66±7.80)的占不合理处方类型的总数略有上升,提示仍需实施持续性整改。结论:通过实施提升药师对他汀类药物的处方审核干预综合技能的措施,对他汀类药物的潜在不合理用药风险有降低趋势,为临床确保患者用药安全提供参考。OBJECTIVE To analyze the rational clinical use of statins through strengthening the pharmacist review and intervention,to promote rational clinical use of statins and reduce adverse reactions.METHODS Statistics and analysis were conducted for the rational use of statins from January to June in2016（before intervention）and from January to June in2017.RESULTS After reformation,the irrational types of statins in total prescriptions sampled：the statins unreasonable rate（2.57±0.11 vs.1.47±0.25）,clinical diagnosis（0.68±0.16 vs.0.62±0.08）,repeat medication（0.33±0.05 vs.0.06±0.02,P〈0.01）,dosage unreasonable（0.73±0.21 vs.0.43±0.16）,combination unreasonable（0.94±0.09 vs.0.37±0.12,P〈0.05）have downward trend;The statins irrational type accounted for the total irrational prescriptions：repeat medication（12.65±1.84 vs.4.16±1.95,P〈0.05）,combination unreasonable（36.75±4.01 vs.24.79±7.06,P〈0.05）have downward trend,but clinical diagnosis（26.67±6.61 vs.42.38±3.61）and dosage unreasonable（23.95±4.86 vs.28.66±7.80）have slightly increased.CONCLUSION Strengthening the pharmacist review and intervention of statins can reduce the potential risk of irrational use of statins and ensure the clinical safety.

关 键 词：处方审核干预 他汀类药物 合理用药 

分 类 号：R969.3[医药卫生—药理学]