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中国某糖尿病病房药学服务的评估:一项干预前后的研究。

Evaluation of pharmaceutical care in a diabetes ward from China: a pre-and post-intervention study.

作者信息

Xin Chuanwei, Ge Xing, Zheng Liujuan, Huang Ping

机构信息

Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China.

出版信息

Int J Clin Pharm. 2016 Feb;38(1):34-40. doi: 10.1007/s11096-013-9855-z. Epub 2013 Oct 17.

Abstract

OBJECTIVE

To describe the development and implementation of pharmaceutical care services in a diabetes ward, and to examine the effectiveness of pharmacist interventions.

SETTING

Tongde hospital of Zhejiang province, a 1,200-bed South China teaching hospital, serving the local community.

METHOD

A single-center, 2-phase (pre-/post-intervention phase) designs was performed in the diabetes ward of a general hospital. Patients in post-intervention phase (October 2012 to December 2012) received pharmaceutical care from a clinical pharmacist, while patients in the pre-intervention phase (January 2012 to March 2012) received routine medical care. The pre- and post-intervention phases were then compared to evaluate the outcomes of pharmacist interventions. Main outcome measure type and number of interventions, and medication errors assessed at the baseline and at the end of pharmaceutical care were the main outcome measures.

RESULTS

During the 3-month study period, the clinical pharmacist made 240 interventions for 473 admitted patients; of these, 207 (86.3 %) were accepted by physicians or nurses, and dosage adjustment [n = 83, (34.6 %)] was the type of intervention implemented most often. In the group that received the participation of pharmacists, medication errors per patient decreased from 1.68 to 0.46 (p < 0.001); medication errors, of incorrect dose or dosing interval, were markedly improved (decreased from 0.87 to 0.14; p < 0.001), the drug cost per patient day decreased from $347.15 to $309.74 (p = 0.095), and the length of diabetes ward stay did not change significantly (16.14 vs. 15.93 days; p = 0.15).

CONCLUSION

The presence of the pharmacist in the diabetes ward resulted in significant reduction in medication errors and had potential drug-cost-saving effects.

摘要

目的

描述糖尿病病房药学服务的开展与实施情况,并考察药师干预的效果。

背景

浙江省同德医院,一家拥有1200张床位的华南教学医院,为当地社区提供服务。

方法

在一家综合医院的糖尿病病房进行单中心、两阶段(干预前/干预后阶段)设计。干预后阶段(2012年10月至2012年12月)的患者接受临床药师的药学服务,而干预前阶段(2012年1月至2012年3月)的患者接受常规医疗护理。然后比较干预前和干预后阶段,以评估药师干预的结果。主要结局指标为干预的类型和数量,以及在药学服务基线和结束时评估的用药差错。

结果

在3个月的研究期间,临床药师对473名入院患者进行了240次干预;其中,207次(86.3%)被医生或护士接受,剂量调整[n = 83,(34.6%)]是最常实施的干预类型。在接受药师参与的组中,每位患者的用药差错从1.68降至0.46(p < 0.001);剂量或给药间隔错误的用药差错明显改善(从0.87降至0.14;p < 0.001),每位患者每天的药物费用从347.15美元降至309.74美元(p = 0.095),糖尿病病房住院时间无显著变化(16.14天对15.93天;p = 0.15)。

结论

糖尿病病房配备药师可显著减少用药差错,并具有潜在的节省药物费用的效果。

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