药师参与多学科诊疗的模式探讨及效果评价  

Investigation of the mode of pharmacist participating in multi-disciplinary diagnosis and treatment and effect evaluation

作　　者：李赟 王立新[2] 郭阳[2] 田杰[2] 刘芳[1,3] LI Yun;WANG Lixin;GUO Yang;TIAN Jie;LIU Fang(Dept.of Pharmacy,the Third Hospital of Peking University,Beijing 100191,China;Dept.of Pharmacy,the First Hospital of Shanxi Medical University,Taiyuan 030001,China;Drug Evaluation Center,Peking University Health Science Center,Beijing 100191,China)

机构地区：[1]北京大学第三医院药剂科,北京100191 [2]山西医科大学第一医院药学部,太原030001 [3]北京大学医学部药品评价中心,北京100191

出　　处：《中国药房》2023年第12期1515-1519,共5页China Pharmacy

基　　金：首都卫生发展科研专项项目(No.首发2020-1-2031)。

摘　　要：目的评价药师参与多学科诊疗(MDT)的模式及效果。方法计算机检索Cochrane图书馆、PubMed、Embase、中国知网、中国生物医学文献数据库和万方数据,收集药师参与MDT对患者临床结局影响的试验性研究和观察性研究。提取资料和评价质量后,对纳入研究的结果进行描述性分析。结果共纳入10项研究,其中3项研究为随机对照试验(RCT),2项研究为非RCT,4项研究为队列研究,1项研究为病例对照研究;共计2422例患者。有效性方面,药师参与MDT后患者的肿瘤无进展生存期、糖化血红蛋白、再入院率和住院时间等指标均显著改善。安全性方面,药师参与MDT后患者大出血事件发生率显著降低。经济性方面,药师参与MDT后患者与药物相关的住院费用、平均门诊医疗费用总额均显著改善,但医疗费用未见明显改善。人文结局方面,药师参与MDT后患者的依从性结论存在争议。结论药师根据自身的药学服务技能和方法,全程化地参与MDT,改善了患者的临床结局,提高了用药的安全性,但在经济性和人文结局方面尚存在争议。OBJECTIVE To evaluate the mode of pharmacists’participation in multi-disciplinary diagnosis and treatment(MDT),as well as the effects of pharmacists’participation.METHODS Retrieved from Cochrane Library,PubMed,Embase,CNKI,CBM and Wanfang database,experimental studies and observational studies on the effects of MDT with pharmacists on clinical outcomes of patients were collected.After data extraction and quality evaluation,the results of included studies were analyzed descriptively.RESULTS A total of 10 studies were included,among which 3 were randomized controlled trials(RCT),2 were non-RCT,4 were cohort and 1 was case-control study;there were 2422 patients in total.In terms of effectiveness,tumor progression-free survival,glycosylated hemoglobin,re-admission rate and length of stay and other indexes were all improved significantly after pharmacists participated in MDT.In terms of safety,the incidence of major bleeding events was significantly decreased after pharmacists participated in MDT.In terms of economy,hospitalization costs and total outpatient expenses were improved significantly after pharmacists participated in MDT,but medical cost was not improved significantly.In terms of humanistic outcomes,there was controversy over the conclusion of patient compliance after pharmacists participated in MDT.CONCLUSIONS Pharmacists,based on their own pharmaceutical care skills and methods,actively participate in MDT throughout the process,improving the clinical outcomes of patients and enhancing the safety of medication.There are still controversies regarding economic and humanistic outcomes.

关 键 词：药师 多学科诊疗 系统评价 参与模式 效果 

分 类 号：R95[医药卫生—药学]