基于DRPs的药师参与分类药学监护对慢性阻塞性肺疾病患者用药安全性和监护质量的影响  

Impact of DRPs-based pharmacist's participation in classified pharmaceutical care on medication safety and monitoring quality in patients with chronic obstructive pulmonary disease

作　　者：香雪芳 XIANG Xue-fang(Pharmacy Department,Qishi Hospital of Qishi Town,Dongguan 523500,China)

机构地区：[1]广东省东莞市企石镇企石医院药剂科,523500

出　　处：《中国现代药物应用》2023年第2期156-160,共5页Chinese Journal of Modern Drug Application

摘　　要：目的研究基于药物相关问题(DRPs)的药师参与分类药学监护对慢性阻塞性肺疾病(COPD)患者用药安全性和监护质量的影响。方法120例COPD患者,根据随机数字表法分为监护组和参照组,各60例。参照组患者予常规医护服务,监护组患者在参照组基础上增加基于DRPs的药师参与分类药学监护服务。分析监护组患者DRPs,比较两组患者入院时和出院后3个月运动耐量[6min步行距离(6MWD)]、临床症状控制情况[COPD评估测试(CAT)评分]及不良反应发生情况。结果监护组共发现65个DRPs,涉及治疗有效性问题39个(60.00%)、治疗安全性问题20个(30.77%)、其他问题6个(9.23%);DRPs发生原因78个,其中多与药物选择和患者自身有关,与药物选择有关23个(29.49%),与患者自身有关26个(33.33%);针对医师层面干预39个(60.00%),患者层面干预26个(40.00%),干预接受59个(90.77%),DRPs被完全解决51个(78.46%)。出院后3个月,两组患者6MWD长于本组入院时,CAT评分低于本组入院时,且监护组患者6MWD(296.77±38.72)m长于参照组的(280.50±37.44)m,CAT评分(19.56±3.01)分低于参照组的(21.09±3.18)分,差异具有统计学意义P<0.05)。监护组患者不良反应发生率为8.33%,低于参照组的21.67%,差异具有统计学意义(P<0.05)。结论基于DRPs的药师参与分类药学监护可改善COPD患者的运动耐量、临床症状,有利于降低用药风险,值得临床推广应用。Objective To study the impact of drug-related problems(DRPs)-based pharmacist's participation in classified pharmaceutical care on medication safety and monitoring quality in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 120 patients with COPD were divided into monitoring group and reference group according to the random numerical table,with 60 patients in each group.Patients in the reference group received conventional health care services,and patients in the monitoring group received DRPsbased pharmacist's participation in classified pharmaceutical care on the basis of the reference group.The DRPs of patients in the monitoring group were analyzed,and the exercise tolerance[6-min walking distance(6MWD)],clinical symptom control[COPD assessment test(CAT)score]at admission and 3 months after discharge,and the occurrence of adverse reactions were compared between the two groups.Results 65 DRPs were identified in the monitoring group,involving 39 problems(60.00%)of treatment effectiveness,20 problems(30.77%)of treatment safety,and 6 problems(9.23%)of others.There were 78 causes of DRPs,most of which were related to drug selection and patients themselves,23 causes(29.49%)were related to drug selection,and 26 causes(33.33%)were related to patients themselves;39 interventions(60.00%)were conducted at the physician level,26 interventions(40.00%)were conducted at the patient level,59 interventions(90.77%)were received,and 51 DRPs(78.46%)were completely resolved.At 3 months after discharge,patients in both groups had a longer 6MWD and lower CAT scores than those at admission in this group;the 6MWD(296.77±38.72)m of patients in the monitoring group longer than(280.50±37.44)m in the reference group,and CAT score(19.56±3.01)points was lower than(21.09±3.18)points in the reference group;the differences were statistically significant(P<0.05).The incidence of adverse reactions in patients in the monitoring group was 8.33%,which was lower than 21.67%in the reference group,and the difference was

关 键 词：药物相关问题 分类药学监护 慢性阻塞性肺疾病 用药安全 监护质量 

分 类 号：R969.3[医药卫生—药理学]