Britton M L, Lurvey P L
Department of Veterans Affairs Medical Center, Oklahoma City, OK 73104.
Am J Hosp Pharm. 1991 Feb;48(2):265-70.
The effect of medication profile review by a clinical pharmacist on prescribing in a general medicine clinic was studied. Patients who were receiving five or more prescription or nonprescription medications were randomly assigned to an intervention group (n = 315) or a control group (n = 257). A clinical pharmacist reviewed the medication profile of each intervention group patient on the day before the patient's clinic visit and attached a written profile review to the medical record for study by the physician during the visit. After each clinic day, the pharmacist obtained updated records of patients in both groups and collected data on the number and cost of medications ordered before and after the visits. After the clinic visits, the average number of medications and the average monthly medication cost per patient decreased by 0.21 and $0.60, respectively, for the intervention group, compared with increases of 0.48 and $3.31 for the control group. The net result of a single profile review was a decrease of 0.69 prescription per patient, for a monthly medication cost savings of $3.91. The number and cost of medications that were discontinued were significantly higher in the intervention group. The intervention group also had significantly fewer drugs added for previously documented medical problems. Medication profile review by a clinical pharmacist reduced both the number and cost of drugs for patients receiving five or more medications.
研究了临床药师进行用药情况审查对综合内科门诊处方开具的影响。正在接受五种或更多种处方药或非处方药治疗的患者被随机分为干预组（n = 315）和对照组（n = 257）。临床药师在每位干预组患者门诊就诊前一天审查其用药情况，并在病历中附上书面审查报告，供医生在就诊时参考。每个门诊日结束后，药师获取两组患者的最新记录，并收集就诊前后所开药物的数量和费用数据。门诊就诊后，干预组患者的平均用药数量和平均每月用药费用分别下降了0.21和0.60美元，而对照组则分别增加了0.48和3.31美元。单次用药情况审查的最终结果是每位患者的处方减少了0.69张，每月节省用药费用3.91美元。干预组中停用药物的数量和费用显著更高。干预组中因先前记录的医疗问题而新增的药物也显著更少。临床药师进行用药情况审查降低了接受五种或更多种药物治疗患者的用药数量和费用。
