临床药师对终末期肾病血液透析患者实施药物治疗管理的实践与思考  

Practice and Experience of Medication Therapy Management Service for Patients with End-Stage Renal Disease Who Require Hemodialysis

作　　者：段虹飞[1] 赵淑娟[1] 左兴盛[1] 樊鹏利[1] 孙俊[1] 马培志[1] DUAN Hong-fei;ZHAO Shu-juan;ZUO Xing-sheng;FAN Peng-li;SUN Jun;MA Pei-zhi(Department of Pharmacy,People's Hospital of Henan Province,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院药学部,郑州450000

出　　处：《中国合理用药探索》2021年第12期33-37,共5页Chinese Journal of Rational Drug Use

摘　　要：目的:临床药师针对终末期肾病(ESRD)行血液透析的患者开展药物治疗管理(MTM),探讨其流程和要点。总结血液透析患者常见的药物相关问题(DPRs)并进行干预。方法:选取2021年1月~2021年6月期间本院肾内科收治的ESRD行血液透析的患者为研究对象,由临床药师开展MTM工作并对其流程、主要内容及重点进行归纳和总结。结果:共纳入192例ESRD患者,平均罹患疾病(5.22±1.64)种;平均用药(6.81±2.42)种,用药≥5种的有184例(95.8%)。存在DPRs的患者有105例(54.7%),共计136条。针对DPRs的分类,临床药师及时与医师沟通或向患者提供教育和指导,临床药师干预接受率78.7%。出院前患者用药依从性平均得分为(5.66±1.38)分,80例(41.7%)依从性好,112例(58.3%)依从性差。结论:通过建立标准化的MTM流程,对ESRD行血液透析的患者实施全程化药学服务,能够提高药学服务质量,及时发现并纠正DPRs,保障合理用药。Objective:Clinical pharmacists carry out medication therapy management(MTM)for patients with end-stage renal disease(ESRD)who require hemodialysis,and discuss its process and key points.Summarize the common drug-related problems(DPRs)of hemodialysis patients and conduct intervention.Methods:The inpatients with ESKD who required hemodialysis in the kidney internal medicine department of our hospital from January 2021 to June 2021 were selected as the research subjects.Clinical pharmacists carried out MTM,and summarized the process,main content and key points of MTM work.Results:A total of 192 ESRD patients were conducted.The average of accompanied diseases was(5.22±1.64)and the average of medicine were(6.81±2.42),184(95.8%)cases were treated with more than 5 kinds of drugs.There were 105 cases(54.7%)with DPRs,and the total was 136.According to DPRs classification,clinical pharmacists timely communicated with physicians or provided education and guidance to patients,and the intervention acceptance rate was 78.7%.The average score of patients before discharge was(5.66±1.38).80 cases(41.7%)in the good compliance group and 112 cases(58.3%)in the poor compliance group.Conclusion:The establishment of standardized MTM process can improve the quality of pharmaceutical care,timely find and correct DPRs and ensure rational drug use by implementing full-process pharmaceutical care for hemodialysis patients with ESRD.

关 键 词：终末期肾病 血液透析 药物治疗管理 临床药师 药物相关问题 

分 类 号：R692.5[医药卫生—泌尿科学] R95[医药卫生—外科学]