临床药师参与国家谈判药品临床实践前瞻性研究  

Clinical pharmacists participated in a prospective study about the clinical practice of national negotiated drugs in china

作　　者：李秦川[1] 陈希 姜倩 LI Qin-chuan;CHEN Xi;JIANG Qian(Department of Clinical Pharmacy,Chengdu Second People's Hospital,Sichuan Chengdu 610017,China)

机构地区：[1]成都市第二人民医院临床药学科

出　　处：《中国医院药学杂志》2019年第11期1187-1193,共7页Chinese Journal of Hospital Pharmacy

摘　　要：目的:总结临床药师参与国家谈判药品临床实践的结果和经验。方法:采用前瞻性研究方法,选取2018年1月-2018年7月临床药师参与国家谈判药品临床实践的病历资料,对国家谈判药品使用情况、患者基础信息、治疗方案、不良反应、随访及患者经济获益统计分析。结果:该研究纳入男性患者37例,女性患者28例。临床药师调整治疗方案13例,占比20%;肺癌方案调整9例,占调整方案比例69.23%。不良反应(Adverse Drug Reaction,ADR)26例,占比40%。性别、年龄与ADR发生率比较差异无显著性(P>0.05)。疾病种类用药与ADR发生率比较差异有显著性(P<0.05)。临床药师给予ADR干预措施21条,ADR好转率96.16%。随访150人次,面对面随访116次,占比77.33%。希望电话随访31人,占比58.49%;希望一月随访一次36人,占比67.92%。患者直接用药经济成本最大降幅68.67%。结论:国家谈判药品使患者经济获益明显;临床药师参与国家谈判药品治疗管理,促进患者疾病诊治、优化治疗结局,加强患者ADR处理能力,提高用药依从性;同时对国家谈判药品政策落地提供真实世界依据。OBJECTIVE To summarize the results and experiences of clinical pharmacists participating in national drug clinical practice negotiation. METHODS A prospective study was conducted to select the medical records of clinical pharmacists who participated in national drug negotiation from January 2018 to July 2018. The use of national drug negotiation, basic information of patients, treatment regimen, adverse reactions, follow-up and economic benefits of patients were statistically analyzed. RESULTS The study included 37 male patients and 28 female patients. Clinical pharmacists adjusted treatment regimen in 13 cases, accounting for 20%, among which lung cancer regimen were adjusted in 9 cases, accounting for 69.23%. There were 26 cases of adverse drug reaction(ADR), accounting for 40%. There was no significant difference in gender, age and incidence of ADR(P>0.05). There was a significant difference in the incidence of disease types and medication and ADR(P<0.05). Twenty-one ADR interventions were conducted by clinical pharmacists and the patient’s ADR were significantly reduced with a improvement rate of 96.16% after the intervention. There were 150 follow-ups and 116 face-to-face follow-ups, accounting for 77.33%. According to the results of the patient’s questionnaire survey, the follow-up via telephone was expected in 31 patients who accounted for 58.49%. The follow-up once a month was expected in 36 patients who accounted for 67.92%. The largest decrease in the economic cost of direct medication in patients was 68.67%. CONCLUSION The national negotiation of drugs has obvious economic benefits for patients;clinical pharmacists’ participation in national negotiation of drug treatment management could promote the diagnosis and treatment of patients with diseases;Meanwhile, it helps to provide real world basis for national negotiation of drug policy.

关 键 词：药物治疗管理 国家谈判药品 不良反应 药学监护 

分 类 号：R952[医药卫生—药学]