基于高质量循证用药指南制定与实施的临床药学“实践-研究一体化”模式构建与实践  

Construction and practice of the"practice-research integration"mode for clinical pharmacy based on the development and implementation of highquality evidence-based medication guidelines

作　　者：宋再伟 赵荣生[1,2,3] 陈耀龙 徐东[6,7] SONG Zaiwei;ZHAO Rongsheng;CHEN Yaolong;XU Dong(Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Drug Evaluation Center,Peking University Health Science Center,Beijing 100191,China;Therapeutic Drug Monitoring and Clinical Toxicology Center,Peking University,Beijing 100191,China;Research Innovation Unit of Evidence-based Evaluation and Guidelines,Chinese Academy of Medical Sciences,The School of Basic Medical sciences,Lanzhou University,Lanzhou 730000,China;The Gansu Provincial Key Laboratory of Evidence Based Medicine,Lanzhou 730000,China;Acacia Lab for Implementation Science Laboratory,Department of Health Management,School of Health Management,Southern Medical University,Guangzhou 510515,China;The World Health Organization Research Center,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]北京大学第三医院药学部,北京100191 [2]北京大学医学部药物评价中心,北京100191 [3]北京大学治疗药物监测和临床毒理学中心,北京100191 [4]中国医学科学院循证评价与指南研究创新单元,兰州大学基础医学院,兰州730000 [5]甘肃省循证医学重点实验室,兰州730000 [6]南方医科大学卫生管理学院卫生管理系Acacia实施科学实验室,广州510515 [7]南方医科大学世界卫生组织研究中心,广州510515

出　　处：《中国临床药学杂志》2024年第6期401-407,共7页Chinese Journal of Clinical Pharmacy

基　　金：国家自然科学基金资助项目(编号72304007,72074005);中央高校基本科研业务费资助项目(编号BMU2022XY004-01)。

摘　　要：目的探索基于高质量循证用药指南制定与实施的临床药学“实践-研究一体化”模式,助推临床药学学科建设。方法阐述高质量循证用药指南制定与实施过程,构建临床药学“实践-研究一体化”模式,并以《中国大剂量甲氨蝶呤循证用药指南》为例探讨实践过程。结果建立了“合理用药临床研究-药物循证评价研究-循证用药指南制定-指南实施性研究”的研究体系,凝练出“循证药学证据生态系统”的特色学科发展方向,探索出临床药学B-E-P(Bedside-Evidence-Practice)的“实践-研究一体化”模式。基于《中国大剂量甲氨蝶呤循证用药指南》实施,临床药师成功解救了1例大剂量甲氨蝶呤治疗后出现严重排泄延迟及急性肾损伤的患者。结论实施以高质量循证用药指南为基础的临床药学“实践-研究一体化”模式,可助力提升药师药学服务能力,提高临床药物治疗水平,并促进临床药学学科建设与发展。AIM To explore the"practice-research integration"mode of clinical pharmacy based on the formulation and implementation of high-quality evidence-based medication guidelines,and boost the construction of clinical pharmacy discipline.METHODS The formulation and implementation process of high-quality evidence-based medication guidelines was explained,the"practice-research integration"mode of clinical pharmacy was established,and the practice process of the"Evidence-based guideline of medication therapy of high-dose methotrexate"was discussed as an example.RESULTS A research system of"clinical research of rational drug use-drug evidence-based evaluation research-evidence-based medication guideline formulation-guideline implementation research"was established,the characteristic discipline development direction of"evidence-based pharmacy evidence ecosystem"was summarized,and the"practice-research integration"mode of clinical pharmacy B-E-P(Bedside-Evidence-Practice)was explored.Based on the"Evidence-based guideline of medication therapy of high-dose methotrexate",the clinical pharmacist successfully rescued a patient with severe excretion delay and acute kidney injury after high-dose methotrexate treatment.CONCLUSION The implementation of the"practice-research integration"mode of clinical pharmacy based on highquality evidence-based medication guidelines can contribute to enhancing pharmacists'pharmaceutical service capabilities,improving the professional level of clinical drug therapy,and promoting the construction and development of clinical pharmacy discipline.

关 键 词：指南制定 指南实施 临床药学 循证药学 证据生态系统 

分 类 号：R95[医药卫生—药学]