Mekonnen Alemayehu B, Yesuf Elias A, Odegard Peggy S, Wega Sultan S
School of Pharmacy, University of Gondar. Gondar (Ethiopia).
Pharm Pract (Granada). 2013 Jan;11(1):51-7. doi: 10.4321/s1886-36552013000100009. Epub 2013 Mar 28.
Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.
To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital.
The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist) using a standardized method for categorizing drug related problems (DRPs).
A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3%) were clinical pharmacists initiated interventions and 16(10.7%) interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%); needs additional drug therapy, 34(22.8%) and noncompliance, 29(19.5%). The most frequent intervention type was change of dosage/instruction for use, 23(15.4%). Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9%) and 25(26.6%) had major and moderate clinical importance respectively.
Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This approach can likely be generalized to other health care settings in the country to improve medication outcomes.
临床药学实践在国际上已得到发展，药剂师的角色已从传统的配药、发药和供药大幅扩展到更直接参与患者护理的角色。然而，在资源有限的环境中，关于临床药剂师在住院病房活动的研究却很匮乏。
评估吉姆马大学专科医院内科病房基于病房的临床药学服务。
该研究于2011年3月至4月在吉姆马大学专科医院内科病房开展。研究设计为前瞻性观察性研究，记录临床药剂师在两个月内为住院患者提供的药学服务。记录了诸如优化合理用药以及医生对这些建议的接受情况等干预措施。由一个独立团队（1名内科医生、1名临床药理学家）使用标准化方法对药物相关问题（DRP）进行分类，评估干预措施的临床意义。
共记录了为48名患者实施的149项药物相关干预措施；其中133项（89.3%）是临床药剂师发起的干预措施，16项（10.7%）干预措施由其他医护人员发起。干预措施背后最常见的DRP是不必要的药物治疗，共36项（24.2%）；需要额外的药物治疗，34项（22.8%）以及用药依从性不佳，29项（19.5%）。最常见的干预类型是改变剂量/使用说明，共23项（15.4%）。医生的接受率为68.4%。在被评为具有临床意义的干预措施中，分别有46项（48.9%）和25项（26.6%）具有重大和中度临床重要性。
让训练有素的临床药剂师加入医疗团队可在资源有限的环境中实现与临床相关且被广泛接受的用药优化。这种方法可能推广至该国其他医疗环境，以改善用药效果。
