欧洲医药保健网分类系统在中枢神经系统药物相关问题中的干预效果评价  

Evaluation of the effects of pharmaceutical care network Europe classification system on the drug-related problems in clinical application of central nervous system medications

作　　者：姜倩 范芳芳[1,2] 姚莉 郑丽丽[1,2] 胡兰 赵生俊[1,2] JIANG Qian;FAN Fangfang;YAO Li;ZHENG Lili;HU Lan;ZHAO Shengjun(Department of Pharmacy,Xinjiang Uygur Autonomous Regional Academy of Traditional Chinese Medicine,Urumqi,Xinjiang Uygur Autonomous Region 830000,China;Department of Pharmacy,The Affiliated Traditional Medical Hospital,Xiniang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830000,China)

机构地区：[1]新疆维吾尔自治区中医药研究院,新疆维吾尔自治区乌鲁木齐830000 [2]新疆医科大学附属中医医院药学部,新疆维吾尔自治区乌鲁木齐830000

出　　处：《安徽医药》2023年第11期2313-2317,共5页Anhui Medical and Pharmaceutical Journal

基　　金：新疆维吾尔自治区药学会科研基金资助项目(YXH201912)。

摘　　要：目的运用欧洲医药保健网(PCNE)分类系统对中枢神经系统药物相关问题(DRPs)进行分析与评估,为临床药师进行合理用药提供依据。方法选择2020年7月至2021年7月入住新疆医科大学附属中医医院神经内科并且服用中枢神经系统药物的病人,临床药师从药学服务中对发现的DRPs进行干预,并借助PCNE(V9.0)分类系统进行分类汇总。结果纳入654例服用中枢神经系统药物的病人,106例(16.21%)病人共发生112个DRPs。其中DRPs的问题类别集中在治疗安全性(74.11%)和治疗有效性(16.07%)。DRPs发生频率较高的药物为抗精神病药、苯二氮䓬类药、抗焦虑抑郁药、解热镇痛抗炎药及抗痴呆药和改善脑代谢药。DRPs的原因主要是药物选择(79.65%),其次是剂量选择(9.73%)。临床药师共进行了257次介入,其中207次介入被接受,成功率为80.54%。干预接受程度最高的是药物不良反应上报(100%),其次是与病人层面(96.97%)、药物层面(77.98%)及医师层面(76.42%)。发生9例(1.37%)药物不良反应,临床药师参与评价及干预,9例病人均转归良好。结论PCNE分类系统的引入能提升临床药师发现和解决DRPs的能力,提高临床药师在药学服务中的能力及效率,促进临床合理用药。Objective To analyze and evaluate the drug-related problems(DRPs)of central nervous system(CNS)medications by using the pharmaceutical care network Europe(PCNE)classification system,so as to provide reference for pharmacists to practise pharmaceutical care mode in patients.Methods The neurology inpatients receiving central nervous system(CNS)medication were selected from Affiliated Traditional Medical Hospital,Xinjiang Medical University from July 2020 to July 2021.Clinical pharmacists intervened in the DRPs discovered in pharmaceutical care and classified and summarized them with the help of PCNE(V9.0)classification system.Results A total of 654 inpatients with CNS medication were included,of whom 106 patients(16.21%)developed 112 DRPs.The DRPs question categories focused on safety of treatmentt(74.11%)and efficacy of treatment(16.07%).Drugs with higher frequency of DRPs are antipsychotics,benzodiazepines,anti-anxiety and depression drugs,antipyretic,analgesic,anti-inflammatory and anti-dementia drugs,and drugs that improve brain metabolism.The reason categories mainly focus on drug selection(79.65%)and dose selection(9.73%).Clinical pharmacists conducted 257 interventions,207 of which were accepted,with a success rate of 80.54%.The highest acceptance of intervention was adverse drug events reporting(100%),followed by patient level(96.97%),drug level(77.98%)and doctor level(76.42%).Adverse drug reactions occurred in 9 patients(1.37%),whom recovered well with the intervention of clinical pharmacists.Conclusion The introduction of PCNE classification system can improve the ability of clinical pharmacists to discove and solve DRPs,improve the ability and efficiency of clinical pharmacists in pharmaceutical care,promote clinical rational drug use.

关 键 词：中枢神经系统药物 药物相关性副作用和不良反应 欧洲医药保健网分类系统 药物相关问题 药学监护 

分 类 号：R95[医药卫生—药学]