Ibañez-Cuevas Victoria, Lopez-Briz Eduardo, Guardiola-Chorro M Teresa
Official College of Pharmacists, Valencia, Spain.
Pharm World Sci. 2008 Dec;30(6):947-54. doi: 10.1007/s11096-008-9258-8. Epub 2008 Oct 19.
To establish a detection and intervention strategy in order to reduce the number of non-steroidal anti-inflammatory drug (NSAIDs) users at risk of gastropathy from receiving either inadequate or no gastroprotection.
Community Pharmacies in Valencia, Spain.
Prospective longitudinal intervention study without control group carried out by 79 Community Pharmacies. Patients over 18 who asked for any systemic NSAID were interviewed according to standard procedure. Pharmacist intervention was carried out when a patient at risk of serious NSAID-induced gastrointestinal complications due to inadequate or no gastric protection was identified. The doctor responsible was informed in order to then be able to assess the need to prescribe gastroprotection or change it if inadequate. In the case of over-the-counter (OTC) drugs, pharmacist intervention mainly involved replacing NSAIDs for safer medications.
Firstly, the number of patients who had no prescribed gastroprotection or inadequate gastroprotection was determined. Pharmacist intervention then brought about changes in pharmacotherapy in this situation.
Of the 6,965 patients who asked for NSAIDs during the study period, 3,054 (43.9%) presented NSAID gastropathy risk factors. 35.6% of the latter (1,089) were not prescribed gastroprotection or were prescribed inadequate gastroprotection. Pharmacist intervention was carried out in 1,075 of these cases. On 391 occasions such risk situations were reported to doctors, who accepted pharmacist intervention on 309 occasions (79.0%) and then either prescribed gastroprotection (77% of cases); changed it (13.9%); withdrew the NSAID (5.8%) or substituted it (3.2%). 235 Pharmacist interventions took place when dispensing OTC NSAIDs.
Our strategy allowed us to identify a large number of patients who asked for NSAIDs in Community Pharmacies and who were at risk of NSAID gastropathy, as they received either inadequate gastroprotection or no gastroprotection whatsoever. Moreover, the pharmacist intervention carried out has reduced the number of these risk situations.
建立一种检测与干预策略，以减少有患胃病风险的非甾体抗炎药（NSAIDs）使用者未接受充分胃保护或未接受任何胃保护的情况。
西班牙巴伦西亚的社区药房。
由79家社区药房开展的无对照组的前瞻性纵向干预研究。按照标准程序对18岁以上要求使用任何全身性NSAIDs的患者进行访谈。当识别出因胃保护不足或无胃保护而有发生严重NSAID诱导的胃肠道并发症风险的患者时，进行药师干预。通知负责医生，以便其随后能够评估开具胃保护药物的必要性，或在胃保护不足时进行调整。对于非处方药（OTC），药师干预主要包括用更安全的药物替代NSAIDs。
首先，确定未开具胃保护药物或胃保护不足的患者数量。在此情况下，药师干预随后带来了药物治疗的改变。
在研究期间要求使用NSAIDs的6965例患者中，3054例（43.9%）存在NSAID胃病风险因素。其中35.6%（1089例）未开具胃保护药物或开具的胃保护不足。对其中1075例进行了药师干预。在391次此类风险情况中报告给了医生，医生接受药师干预309次（79.0%），随后开具胃保护药物（77%的情况）；进行调整（13.9%）；停用NSAID（占5.8%）或进行替代（占3.2%）。在分发OTC NSAIDs时进行了235次药师干预。
我们的策略使我们能够识别出大量在社区药房要求使用NSAIDs且有NSAID胃病风险的患者，因为他们接受的胃保护不足或根本没有接受任何胃保护。此外，所进行的药师干预减少了这些风险情况的数量。
