Le Guen R, Madelaine I, Tournamille J-F, Bellanger A, Astier A, Braguer D, Ollivier C, Bardin C, Lemare F, Daouphars M, Pinguet F, Latour J-F, Vigneron J, Tilleul P
Pharmacie Pitié-Salpêtrière, 47, boulevard de l'hôpital, 75013 Paris, France.
Pharmacie St-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Ann Pharm Fr. 2015 May;73(3):223-8. doi: 10.1016/j.pharma.2014.10.002. Epub 2014 Nov 12.
Pharmaceutical analyses of chemotherapy prescriptions by hospital pharmacists are activities codified by regulation and rules (bon usage). The involvement of the pharmacists in clinical pharmacy activities in the oncology setting is not clearly identified, justifying the development of a mapping of these activities from a questionnaire addressed to the professionals. One hundred and seven centers have participated to this study at the national level (overall participation rate of 32.4%). More than 95% of them used a computerized ordering system and three quarter of them submit the introduction of new compounds to an analysis by the drug therapeutic committee. Prescription analysis allowed detecting around 2% of errors from the current prescription. Clinical pharmacist participates to tumor boards of onco-hematology (RCP) at a level of 46% for senior pharmacist and 42% for junior pharmacist. This involvement in the RCP allowed anticipating protocol's modification and temporary used authorization. Ninety-two percent of the senior pharmacists estimate that they highlight the risk of no reimbursement for prescription out of the guideline during RCP, resulting to a modification of the prescription for 40% of them. This level of intervention is lower with respectively 64% and 10% for the juniors. This study underlines the expert value of the clinical pharmacist dedicated to oncology setting in pre and post analysis prescriptions. It could be targeted by a prospective analysis of both clinical and pharmacoeconomics impact of these interventions.
医院药剂师对化疗处方进行药学分析是有相关法规和规范(良好操作规范)规定的活动。药剂师在肿瘤学环境下参与临床药学活动的情况尚不明确,这使得有必要通过向专业人员发放问卷来梳理这些活动。全国有107个中心参与了这项研究(总体参与率为32.4%)。其中超过95%的中心使用了计算机化医嘱系统,四分之三的中心会将新化合物的引入提交给药物治疗委员会进行分析。处方分析能够从当前处方中检测出约2%的错误。临床药剂师参与肿瘤血液学多学科会诊(RCP)的比例,高级药剂师为46%,初级药剂师为42%。参与RCP能够预测方案的修改并获得临时使用授权。92%的高级药剂师估计他们在RCP期间会指出指南外处方无法报销的风险,其中40%的处方因此得到修改。初级药剂师在这方面的干预水平较低,分别为64%和10%。这项研究强调了专注于肿瘤学环境的临床药剂师在处方前和处方后分析中的专业价值。可以通过对这些干预措施的临床和药物经济学影响进行前瞻性分析来进一步研究。