临床药师应用MTM对2型糖尿病患者医嘱干预的效果评价  

Evaluation of the effectiveness of clinical pharmacists’application of MTM in medically prescribed interventions for patients with type 2 diabetes mellitus

作　　者：彭媛 吴萍[2] PENG Yuan;WU Ping(Department of Pharmacy,the Second People’s Hospital of Baoshan,Yunnan Province,Baoshan 678000,China;Department of Pharmacy,the First People’s Hospital of Changzhou,Jiangsu Province,Changzhou 213000,China)

机构地区：[1]云南省保山市第二人民医院药学部,保山678000 [2]江苏省常州市第一人民医院药学部,常州213000

出　　处：《上海医药》2024年第9期114-117,126,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：常州市科技局指导性项目(CJ20199007)。

摘　　要：目的:探讨药物治疗管理(MTM)在专科临床药师医嘱干预中的作用。方法:选取2型糖尿病住院患者600例,随机分为对照组和干预组,各300例。对照组未以MTM为依据进行医嘱干预,干预组由临床药师以MTM进行医嘱干预。比较两组不合理医嘱情况。结果:共存在不合理医嘱290条,对照组232条,干预组58条;在药物适应证、安全性、有效性用药问题方面,干预组医嘱不合理率低于对照组(P<0.05)。排列前3位的不合理医嘱分别为:无适应证用药、药物相互作用减少了药物的有效剂量、所用药物对当前病症无效。结论:临床药师以MTM为依据进行医嘱审核干预,可以提高医嘱审核的工作质量,促进临床合理、安全用药。Objective:To explore the role of medication therapy management(MTM)in the intervention of the medical orders by specialty clinical pharmacist and physician.Methods:Six hundred hospitalized patients with type 2 diabetes mellitus were randomly divided into a control group and an intervention group with 300 cases each.The control group was not intervened with medical orders based on MTM while the intervention group was intervened with MTM by clinical pharmacists.The irrational medical orders were compared between the two groups.Results:There were a total of 290 unreasonable medical prescriptions,232 in the control group and 58 in the intervention group.In terms of drug indications,safety,and efficacy medication issues,the rate of unreasonable medical prescriptions in the intervention group was lower than that in the control group(P<0.05).The top three unreasonable medical prescriptions were the medication without indications or no effectiveness for the current condition and the reduction of effective dose due to drug interactions.Conclusion:Clinical pharmacists perform intervention of medical orders based on MTM,which can improve the quality of medical order review and promote the rational and safe use of drugs in clinical practice.

关 键 词：医嘱审核 药物治疗管理 糖尿病 

分 类 号：R197.1[医药卫生—卫生事业管理] R587.1[医药卫生—公共卫生与预防医学]