Bédard M, McLean W
Ottawa General Hospital, Ontario.
Can J Hosp Pharm. 1994 Dec;47(6):268-76.
Clinical pharmacokinetics represents a way to ensure that a patient is receiving an optimal dose of a given drug for a specific indication. Pharmacokinetic consultation services have been implemented in many teaching hospitals and tertiary care facilities in the past. This project evaluated the feasibility of expanding the process to several community hospitals with one coordinator. Twenty-seven hospitals, members of the Ottawa Valley Regional Drug Information Service, were approached. Fifty-two pharmacists from 21 sites agreed to participate. Four modules were taught: basic principles, theophylline, aminoglycosides, and digoxin. Regular follow-up meetings were arranged so pharmacists from different hospitals could share their administrative and patient-specific problems and solutions. After two years, 16 departments have implemented a clinical pharmacokinetic service and monitor 82% of targeted drug levels. The pharmacists trained in clinical pharmacokinetics through the project recommended changes in the regimen in 45% of all their consultations. Eight-one percent of these were accepted and implemented by physicians. These results indicate that pharmacists from small community hospitals can be trained by one individual to provide clinical pharmacokinetic services with minimal supervision. It also shows that these hospitals have a need for such services.
临床药代动力学是一种确保患者针对特定适应症接受给定药物最佳剂量的方法。过去，许多教学医院和三级医疗设施都开展了药代动力学咨询服务。该项目评估了由一名协调员将该流程扩展至几家社区医院的可行性。研究人员联系了渥太华谷地区药物信息服务的27家成员医院。来自21个地点的52名药剂师同意参与。培训了四个模块：基本原则、茶碱、氨基糖苷类药物和地高辛。安排了定期的跟进会议，以便不同医院的药剂师能够分享他们在管理和患者特定问题及解决方案方面的经验。两年后，16个科室实施了临床药代动力学服务，并监测了82%的目标药物水平。通过该项目接受临床药代动力学培训的药剂师在所有咨询中，有45%建议调整治疗方案。其中81%被医生接受并实施。这些结果表明，小型社区医院的药剂师可以由一人进行培训，在最少监督的情况下提供临床药代动力学服务。这也表明这些医院对这类服务有需求。
