精准药学服务体系的建设实践与应用成效分析  

Construction of Precision Pharmaceutical Care System and Its Application Effect

作　　者：卢进[1] 霍炎[1] 万丽丽[1] 杨全军[1] 李婕[1] 张孟琦 辛博 黄金路[1] 郭澄[1] LU Jin;HUO Yan;WAN Lili;YANG Quanjun;LI Jie;ZHANG Mengqi;XIN Bo;HUANG Jinlu;GUO Cheng(Department of Pharmacy,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University,Shanghai,China 200233)

机构地区：[1]上海交通大学附属第六人民医院药剂科,上海200233

出　　处：《中国药业》2021年第23期5-7,共3页China Pharmaceuticals

基　　金：国家自然科学基金[81872494];上海市卫生健康委科研课题[20194Y0052];上海市第六人民医院院级科学研究基金[ynlc201826]。

摘　　要：目的为临床合理用药和精准用药服务提供参考。方法构建基于治疗药物监测的全科室精准药学服务体系,并持续改进,包括规范临床取样时间点及样本检测时间,多重技术验证检测结果准确度,异常检测数值的药学追踪与个体化用药报告出具,构建精准药学服务体系,开展样本库和数据库建设及个体化用药临床研究。结果已推进11个品种(14个项目)的血药浓度检测,辅助26种药物的相关药物代谢动力学/药效动力学基因检测;药师对临床决策的干预率由2019年的60.15%升至2020年的98.78%,干预成功率由93.95%升至96.49%。结论该精准药学服务体系丰富了临床用药的药品知识库与规则知识库,有助于制订个体化用药方案,可更好地服务于临床治疗。Objective To provide a reference for clinical rational drug use and precision pharmaceutical care.Methods A department-wide precision pharmaceutical care system based on therapeutic drug monitoring(TDM)was constructed and continuously improved,including standardizing the clinical sampling time point and sample detection time,verifying the accuracy of detection results with multi-ple technologies,pharmaceutical tracking of abnormal detection values and providing individualized medication reports,the construction of precision pharmaceutical care system,the construction of sample banks and related databases,and the clinical research of individualized medication.Results The project has promoted the blood drug concentration detection of 11 varieties(14 projects),and assisted the related pharmacokinetic/pharmacodynamic genetic testing of 26 drugs.The intervention rate of pharmacists in clinical decision-making increased from 60.15%in 2019 to 98.78%in 2020,and the success rate of intervention increased from 93.95%to 96.49%.Conclusion The precision pharmaceutical care system enriches the drug knowledge base and rule knowledge base of clinical medi-cation,helps to formulate individualized medication plans,and can better serve clinical treatment.

关 键 词：治疗药物监测 精准药学服务体系 临床决策 合理用药 药房管理 

分 类 号：R95[医药卫生—药学]