临床药学服务对奈玛特韦片/利托那韦片合理使用的影响  

Effect of clinical pharmaceutical care on rational use of nirmatrelvir/ritonavir tablets

作　　者：支旭然 邹杨[1,3] 高丽君 覃旺军 孔旭东[1] 赵莉[1] 郭冬杰[1] 李朋梅[1] 张相林[1] 刘丽宏[1] ZHI Xu-ran;ZOU Yang;GAO Li-jun;QIN Wang-jun;KONG Xu-dong;ZHAO Li;GUO Dong-jie;LI Peng-mei;ZHANG Xiang-lin;LIU Li-hong(Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pharmacy,Hebei General Hospital,Hebei Key Laboratory of Clinical Pharmacy,Shijiazhuang 050000,China;Department of Clinical Pharmacy,Xiangtan Central Hospital,Hunan Xiangtan 411100,China;Department of Pharmacy,Beijing Aerospace General Hospital,Beijing 100076,China)

机构地区：[1]中日友好医院药学部,北京100029 [2]河北省人民医院药学部河北省临床药学重点实验室,石家庄050000 [3]湘潭市中心医院临床药学科,湖南湘潭411100 [4]北京航天总医院药学部,北京100076

出　　处：《临床药物治疗杂志》2024年第3期50-54,共5页Clinical Medication Journal

基　　金：国家重点研发计划“主动健康和人口老龄化科技应对”重点专项(2022YFC3602201);中央高水平医院临床业务费专项临床研究项目(2022-NHLHCRF-YSPY-02-05);中日友好医院“菁英计划”人才培育工程(ZRJY2023-GG15)。

摘　　要：目的探讨临床药学服务对临床初始使用奈玛特韦片/利托那韦片合理性的影响,为新药的临床药学服务模式提供参考。方法回顾性分析2022年12月10日至2023年1月10日中日友好医院使用奈玛特韦片/利托那韦片住院患者的病历资料。根据药物使用时间,将2022年12月10日—20日使用该药物的患者纳入干预初期组,为初步实施临床药学服务阶段,包括前置审核维护、用药指导和疑难病例会诊;12月21日—31日使用该药物的患者纳入干预中期组,为逐步优化临床药学服务阶段;2023年1月1日—10日使用该药物的患者纳入干预后期组,为优化后临床药学服务阶段,在上述基础上加强前置审核和重点宣教。比较各组联用药物不适宜、肝肾损伤患者的用法用量不适宜情况。结果共纳入452例患者,其中干预初期组54例,干预中期组353例,干预后期组45例。与干预初期组比,干预中期组和干预后期组的联用药物不适宜占比、肾损伤患者用法用量不适宜占比均降低(51.9%比33.4%和24.4%,59.3%比29.7%和17.8%),且干预后期组低于干预中期组,差异有统计学意义(P<0.05)。各组肝损伤患者用法用量不适宜占比比较,差异无统计学意义(P>0.05)。会诊咨询内容共计79例次,医师意见采纳72例次(91.1%)。结论临床药学服务对奈玛特韦片/利托那韦片的合理使用发挥了积极作用,且减少了临床用药问题。Objective To explore the influence of clinical pharmaceutical care on the rational initial use of nirmatrelvir/ritonavir tablets,providing a reference for the clinical pharmaceutical care model of new drugs.Methods A retrospective analysis was conducted on the medical records of inpatients treated with nirmatrelvir/ritonavir tablets at the China-Japan Friendship Hospital from December 10,2022,to January 10,2023.According to the time of drug use,patients who used the drug from December 10 to 20,2022 were included in the initial intervention group for the initial implementation of clinical pharmacy services,including pre-audit maintenance,medication guidance,and consultation of complex cases.Patients who used this drug from December 21 to 31 were included in the mid-intervention group,representing the stage of gradual optimization of clinical pharmaceutical care.Patients who used this drug from January 1 to 10,2023 were included in the late-intervention group,representing the stage after optimizing clinical pharmacy services,with strengthened pre-review and key education.The proportions of inappropriate combined medication use and inappropriate dosage for patients with liver or kidney damage were compared among the groups.Results A total of 452 patients were included,including 54 cases in the initial intervention group,353 cases in the mid-intervention group,and 45 cases in the late-intervention group.Compared with the initial intervention group,the proportion of inappropriate combinations of drugs and inappropriate dosages for patients with kidney injury in the mid-intervention group and the late-intervention group were lower(51.9%vs 33.4% and 24.4%,59.3%vs 29.7% and 17.8%),and the late-intervention group was lower than the mid-intervention group,the differences were statistically significant(P<0.05).The proportions of inappropriate dosages for patients with liver damage showed no significant difference among the groups(P>0.05).A total of 79 consultations were conducted,and 72 sessions(91.1%)were adopted by physic

关 键 词：药学服务 奈玛特韦 利托那韦 新型冠状病毒感染 合理用药 

分 类 号：R978.7[医药卫生—药品] R969.3[医药卫生—药学]