Patel Himanshu, Gurumurthy Parthasarathi
Department of Pharmacy Practice, 75532 JSS College of Pharmacy , Jagadguru Sri Shivarathreeshwara University, Mysore, India.
J Oncol Pharm Pract. 2017 Jan 1:1078155217739684. doi: 10.1177/1078155217739684.
Objective This study was conducted to investigate medication-related problems after implementation of clinical pharmacy services at a speciality oncology care setting. Methods It was a prospective interventional study conducted for a period of three years at a private academic oncology care setting. Paper-based medical records and medication orders were reviewed and patients and care givers were interviewed to understand the treatment plan. All the medication-related problems were identified by clinical pharmacists by performing drug therapy review. Patients were also followed up at ambulatory care and in-patient units to ensure appropriate administration of anti-cancer drugs by nurses. All the medication-related problems were discussed with the concerned clinicians and then were resolved with the interventions of clinical pharmacists. Clinical significance of these interventions were assessed and classified as "Major", "Moderate "and "Minor". Educational, clinical and system-based interventions were developed and implemented to minimize medication-related problems at the study site. Results A total of 1359 medication-related problems were identified from 2120 medication orders reviewed of 1362 patients followed during the study period. The most common medication-related problems were lack of suboptimal supportive care (17.95%), inappropriate administration of medications (14.56%), untreated indication (14.20%), wrong dosing calculations (12.21%), drug-drug interactions (11.62%) and sub-therapeutic dose (11.11%). Clinical pharmacy interventions were made to resolve all the medication-related problems. Clinical significance of majority (n = 504, 37.08%) of medication-related problems was "Moderate" followed by "Major" (n = 434, 31.93%) and "Minor" (n = 421, 30.97%). Conclusion The study has demonstrated the importance of clinical pharmacy services in improving quality and safe use of medicines in oncology practice. Positive feedback of clinicians on clinical pharmacy services was a reflection of acceptance of clinical pharmacy interventions by clinicians.
目的 本研究旨在调查在专科肿瘤护理机构实施临床药学服务后与用药相关的问题。方法 这是一项在一家私立学术性肿瘤护理机构进行的为期三年的前瞻性干预研究。回顾纸质病历和用药医嘱，并对患者及其护理人员进行访谈以了解治疗方案。临床药师通过进行药物治疗评估来识别所有与用药相关的问题。还在门诊护理和住院病房对患者进行随访，以确保护士正确使用抗癌药物。所有与用药相关的问题都与相关临床医生进行了讨论，然后在临床药师的干预下得到解决。评估这些干预措施的临床意义，并将其分类为“重大”“中度”和“轻微”。制定并实施了基于教育、临床和系统的干预措施，以尽量减少研究地点与用药相关的问题。结果 在研究期间对1362例患者的2120份用药医嘱进行回顾后，共识别出1359个与用药相关的问题。最常见的与用药相关的问题是缺乏优化的支持治疗（17.95%）、用药不当（14.56%）、未治疗的适应证（14.20%）、剂量计算错误（12.21%）、药物相互作用（11.62%）和治疗剂量不足（11.11%）。采取了临床药学干预措施来解决所有与用药相关的问题。大多数（n = 504，37.08%）与用药相关问题的临床意义为“中度”，其次是“重大”（n = 434，31.93%）和“轻微”（n = 421，30.97%）。结论 该研究证明了临床药学服务在提高肿瘤治疗中药物质量和安全使用方面的重要性。临床医生对临床药学服务的积极反馈反映了临床医生对临床药学干预措施的认可。
