Department of Pharmacy, Klinikum Fulda gAG, Pacelliallee 4, 36043, Fulda, Germany.
Int J Clin Pharm. 2012 Dec;34(6):828-31. doi: 10.1007/s11096-012-9690-7. Epub 2012 Aug 23.
Drug therapy is getting more complex, thus making it more challenging to prescribe appropriate drug therapy. Accordingly, in clinical practice, a wide range of drug-related problems (DRP) may arise; they are relatively common in hospitalised patients and can result in patient morbidity and mortality, and increased costs.
The objective was to investigate the nature and frequency of DRPs along with pharmaceutical interventions to address them in patients with ischemic stroke from hospital admission to discharge.
From January to June 2011 patients with ischemic stroke, who were taking >2 drugs during hospital stay and at discharge, were recruited. A clinical pharmacist performed medication reconciliation on admission, and checked the medication records during the hospital stay regularly. DRPs were categorized by APS-Doc. Results In total, DRPs occurred in 105/155 (67.7 %) patients: Overall 271 DRPs were documented, with a mean of 1.8 ± 2.0 DRPs per patient. The DRPs occurred mainly in the categories "drug", "indication", and "dosage".
In conclusion, DRPs are relatively common in hospitalised patients and may occur at any part of the prescribing process. The clinical pharmacist can provide a valuable contribution in the multidisciplinary team to an optimized pharmacotherapy in patients with ischemic stroke.
药物治疗变得越来越复杂，因此开具适当的药物治疗方案更具挑战性。因此，在临床实践中，可能会出现各种各样的药物相关问题（DRP）；它们在住院患者中较为常见，可能导致患者发病率和死亡率增加，并增加成本。
本研究旨在调查缺血性脑卒中患者从入院到出院期间药物相关问题的性质和频率，并评估解决这些问题的药物干预措施。
2011 年 1 月至 6 月，招募了住院期间和出院时服用>2 种药物的缺血性脑卒中患者。临床药师在入院时进行药物重整，并且定期检查住院期间的用药记录。药物相关问题按照 APS-Doc 进行分类。
共 155 例患者中有 105 例（67.7%）发生了药物相关问题：共记录了 271 个药物相关问题，平均每位患者有 1.8±2.0 个药物相关问题。药物相关问题主要发生在“药物”、“适应证”和“剂量”类别中。
总之，药物相关问题在住院患者中较为常见，可能发生在处方过程的任何环节。临床药师可以在多学科团队中为优化缺血性脑卒中患者的药物治疗提供有价值的贡献。
