癌症疼痛患者病历中阿片类药物相关问题分析  

Analysis on Drug-related Problem of Opioids in the Medical Record of Patients with Cancer Pain

作　　者：王聪 胡建莉 陈旭[1,2] 解吉奕[1,2] WANG Cong;HU Jianli;CHEN Xu;XIE Jiyi(Department of Pharmacy,Huazhong University of Science and Technology,Wuhan 430022,China;Hubei Province Clinical Research Center for Precision Medicine for Critical Illness,Huazhong University of Science and Technology,Wuhan 430022,China;Cancer Center,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院药剂科,武汉430022 [2]华中科技大学同济医学院附属协和医院湖北省重大疾病精准用药临床医学研究中心,武汉430022 [3]华中科技大学同济医学院附属协和医院肿瘤中心,武汉430022

出　　处：《医药导报》2021年第1期71-74,共4页Herald of Medicine

摘　　要：目的了解癌症疼痛(简称癌痛)控制情况,促进麻醉性镇痛药物的合理使用,减少药物相关问题(DRPs)的发生,讨论临床药师工作切入点与着重点。方法收集并筛选2018年3月—2019年4月华中科技大学同济医学院附属协和医院肿瘤中心癌痛患者病历,运用欧洲医药保健网分类系统(PCNE),对病历中阿片类药物应用的DRPs发生率与原因进行统计、分析。结果癌痛患者568例,其中男356例,女212例;年龄9~86岁,平均年龄(55.56±12.05)岁;原发癌症病例最多为肺癌,其次为胃肠道肿瘤和头颈部肿瘤。发生DRPs144例,占25.35%。主要问题集中在"治疗效果",占77.08%。DRPs原因中因"患者相关"导致的占比最高,达50.98%,其次为"药物选择"原因,占33.33%。细分原因显示因"患者不适宜的给药时间或给药间隔"导致的DRPs比例最高,占24.18%。结论该肿瘤中心大部分癌痛患者都可以获得较理想的镇痛治疗,但仍存在不足;临床药师运用PCNE发现问题和分析原因,可作为药学监护中的参考重点,有助于提高癌痛患者镇痛有效率。Objective To understand the cancer pain control situation in the tumor center of our hospital,to promote the rational use of narcotic analgesics,to reduce the occurrence of drug-related problems(DRPs),and to discuss the role of pharmacists in the future.Methods The medical records of cancer pain patients in the cancer center of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,were collected and screened.The incidence and causes of opioid related problems in the medical records of cancer pain patients in our hospital were analyzed and counted by using the pharmaceutical care network Europe(PCNE)classification system.Results From March 2018 to April 2019,568 patients,including 356 males and 212 females,were identified as cancer pain patients in the tumor center of our hospital.The age was from 9 to 86,average age was(55.56±12.05).Lung cancer was the most common primary cancer,followed by gastrocolic carcinoma and tumors of head and neck.The number of DRPs was 144,accounting for 25.35%.The main problems focused on"therapeutic effect",accounting for 77.08%.The causes of all DRPs were analyzed and summarized,among which"patient-related"causes accounted for the highest DRPs(50.98%),the second factor was"drug selection"(33.33%).Further analysis of the results showed that"Inappropriate timing of administration"caused the highest proportion of DRPs(24.18%).Conclusion Most patients with cancer pain in the tumor center of our hospital obtained ideal pain treatment,but there were still shortcomings.The clinical pharmacists could use PCNE to find problems and causes,find key points in pharmaceutical monitoring,and improve the analgesic efficiency in patients with cancer pain.

关 键 词：阿片类药物 癌症疼痛 欧洲医药保健网分类系统 药物相关问题 

分 类 号：R971.2[医药卫生—药品] R969.3[医药卫生—药学]