Abrogoua Danho Pascal, Kamenan Boua Alexis Thierry, Ahui Brou Jean Marcel, Doffou Elisée
Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmaceutical and Biological Sciences, Félix Houphouët-Boigny University.
Department of Pneumophtisiology, Teaching Hospital of Cocody.
Ther Clin Risk Manag. 2016 Nov 22;12:1749-1756. doi: 10.2147/TCRM.S118442. eCollection 2016.
This study aims to analyze the profile and relevance of pharmaceutical interventions (PIs) in the management of tuberculosis (TB) at inpatient settings.
Cross-sectional descriptive study conducted from March to December 2014 within the inpatient unit of pneumophtisiology department, Ivory Coast. Information collected was based on the classification of drug-related problems (DRPs) and PIs outlined by the French Society of Clinical Pharmacy. A score was assigned to each PI according to the importance of the potential clinical impact. This score was correlated with the severity of clinical consequences avoided by the intervention. The listing of interventions was made by pneumophtisiology specialists. The score assigned to each intervention ranged from 0 (without clinical impact) to 3 (vital clinical impact). The acceptance rate of interventions by physicians was evaluated.
Of 130 patients, 28.5% received PIs. The main reasons for interventions were drug-drug interactions (26.4%), noncompliance with recommendations (24.5%), and adverse effects (24.5%). Antituberculosis drugs were involved in 40.3% of DRPs. Interventions were predominantly proposals for monitoring treatment effectiveness and safety parameters (52.7%) followed by proposals of therapeutic choice (28.1%). All interventions were accepted by the physicians. Most interventions (59.6%) were listed as interventions with significant clinical impact.
The presence of a pharmacist at inpatient setting has contributed to the prevention and resolution of problems related to the pharmacotherapeutic management of TB. Pharmacists can position themselves as major players in the therapeutic management of TB inpatient in resource-limited setting.
本研究旨在分析住院环境中肺结核（TB）管理中药剂学干预（PIs）的概况及相关性。
2014年3月至12月在科特迪瓦的肺病科住院部开展横断面描述性研究。收集的信息基于法国临床药学协会列出的药物相关问题（DRPs）和药剂学干预分类。根据潜在临床影响的重要性为每项药剂学干预赋予一个分数。该分数与干预避免的临床后果严重程度相关。干预清单由肺病科专家制定。赋予每项干预的分数范围为0（无临床影响）至3（关键临床影响）。评估医生对干预的接受率。
130名患者中，28.5%接受了药剂学干预。干预的主要原因是药物相互作用（26.4%）、未遵循建议（24.5%）和不良反应（24.5%）。抗结核药物涉及40.3%的药物相关问题。干预主要是监测治疗有效性和安全性参数的建议（52.7%），其次是治疗选择建议（28.1%）。所有干预均被医生接受。大多数干预（59.6%）被列为具有显著临床影响的干预。
住院环境中有药剂师有助于预防和解决与肺结核药物治疗管理相关的问题。在资源有限的环境中，药剂师可成为肺结核住院患者治疗管理的主要参与者。
