Department of Pharmacy Services, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Clin Transplant. 2012 Mar-Apr;26(2):E149-57. doi: 10.1111/j.1399-0012.2012.01623.x.
Lung transplant recipients have complex drug regimens. Study objectives were to assess drug therapy problems (DTPs), pharmacist recommendations, and patient satisfaction with pharmacist services.
Using a pharmaceutical care assessment process, pharmacists identified DTPs and made therapeutic recommendations. Number of DTPs identified per pharmacist visit was calculated and compared to standard care visits through retrospective chart review. Potential clinical impact of recommendations was evaluated by blinded clinicians. Patient satisfaction was assessed via survey.
Fifty-five DTPs were identified in 43 patients over 50 pharmacist visits (1.05 ± 1.34 DTPs per visit). In these same patients, rate of DTP identification was 0.51 ± 0.64 DTPs per standard visit in the preceding two-wk period (p = 0.018 vs. pharmacist visit). The most common DTPs identified by the pharmacist were adverse drug effect (27%) and untreated indication (25%). Overall, 62% of pharmacist recommendations were rated very significant or significant. Survey return rate was 58% and satisfaction scores ranged from 3 to 5 out of 5. Review of medications and teaching regarding the use of medications received the most "very satisfied" and "highly important" scores.
Pharmacists can make valuable contributions in a lung transplant clinic setting by identifying DTPs and making recommendations with a positive impact on patient outcomes and satisfaction.
肺移植受者的药物治疗方案较为复杂。本研究旨在评估药物治疗问题(DTPs)、药师建议以及患者对药师服务的满意度。
药师通过药物治疗评估流程识别 DTP 并提出治疗建议。通过回顾性病历审查,计算每位药师就诊时发现的 DTP 数量,并与标准就诊进行比较。由盲法临床医生评估建议的潜在临床影响。通过问卷调查评估患者满意度。
在 50 次药师就诊中,共 43 名患者发现 55 个 DTP(每次就诊发现 1.05±1.34 个 DTP)。在这些相同的患者中,在前两个 2 周的标准就诊中,DTP 的识别率为 0.51±0.64 个/次(p=0.018 与药师就诊相比)。药师识别出的最常见的 DTP 是药物不良反应(27%)和未治疗的适应证(25%)。总体而言,62%的药师建议被评为非常显著或显著。调查回复率为 58%,满意度评分范围为 3 至 5 分(满分 5 分)。药物评估和用药指导的满意度评分最高,为“非常满意”和“高度重要”。
药师在肺移植门诊环境中可以通过识别 DTP 并提出具有积极影响的建议,为患者的治疗效果和满意度做出重要贡献。