Stemer Gunar, Zehetmayer Sonja, Lemmens-Gruber Rosa
Department of Pharmacology and Toxicology, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
BMC Clin Pharmacol. 2009 Sep 6;9:15. doi: 10.1186/1472-6904-9-15.
The objectives of this pilot study were to evaluate treatment quality for the risk factors of hypertension, diabetes and hyperlipidemia as well as the overall treatment quality for patients on an internal nephrology ward. This evaluation included the collection of data concerning the quality of therapeutic drug monitoring, drug use and potential drug-drug interactions. Establishing such baseline information highlights areas that have a need for further therapeutic intervention and creates a foundation for improving patient care, a subject that could be addressed in future clinical pharmacy research projects.
Medical charts of patients treated on a single internal nephrology ward were retrospectively evaluated using a predefined data collection form. Assessment of further need for therapeutic intervention was performed.
For 76.5% (n = 78) of the total study population (n = 102), there was either a possibility (39.2%, n = 40) or a need (37.3%, n = 38) for further intervention based on the overall assessment. For the risk factors of hypertension, diabetes and hyperlipidemia, the proportions of patients that require further intervention were 78.8% (n = 71), 90.6% (n = 58) and 87.9% (n = 58), respectively. Patients with diabetes or hyperlipidemia were less likely to have optimal risk factor control. The number of drugs prescribed and the number of potential drug-drug interactions were significantly higher after in-hospital treatment.
Risk factor treatment needs optimisation. Risk factor management, systematic medication reviews, and screening for and management of potential drug-drug interactions deserve great attention. Clinical pharmacy services could help in the achievement of treatment goals.
本试点研究的目的是评估内科肾病病房患者高血压、糖尿病和高脂血症危险因素的治疗质量以及总体治疗质量。该评估包括收集有关治疗药物监测质量、药物使用和潜在药物相互作用的数据。建立此类基线信息突出了需要进一步治疗干预的领域,并为改善患者护理奠定了基础,这是未来临床药学研究项目中可以解决的一个主题。
使用预定义的数据收集表对在单个内科肾病病房接受治疗的患者的病历进行回顾性评估。进行了进一步治疗干预需求的评估。
在全部研究人群(n = 102)中,76.5%(n = 78)的患者基于总体评估存在进一步干预的可能性(39.2%,n = 40)或需求(37.3%,n = 38)。对于高血压、糖尿病和高脂血症的危险因素,需要进一步干预的患者比例分别为78.8%(n = 71)、90.6%(n = 58)和87.9%(n = 58)。患有糖尿病或高脂血症的患者不太可能实现最佳危险因素控制。住院治疗后开具的药物数量和潜在药物相互作用的数量显著更高。
危险因素治疗需要优化。危险因素管理、系统的用药审查以及对潜在药物相互作用的筛查和管理值得高度关注。临床药学服务有助于实现治疗目标。