College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Townsville, QLD, 4814, Australia.
Pharmacy Department, Townsville Hospital & Health Services, Townsville, Australia.
Eur J Pediatr. 2018 Aug;177(8):1139-1148. doi: 10.1007/s00431-018-3187-x. Epub 2018 Jun 19.
Clinical pharmacists provide beneficial services to adult patients, though their benefits for paediatric hospital patients are less defined. Five databases were searched using the MeSH terms 'clinical pharmacist', 'paediatric/paediatric', 'hospital', and 'intervention' for studies with paediatric patients conducted in hospital settings, and described pharmacist-initiated interventions, published between January 2000 and October 2017. The search strategy after full-text review identified 12 articles matching the eligibility criteria. Quality appraisal checklists from the Joanna Briggs Institute were used to appraise the eligible articles. Clinical pharmacist services had a positive impact on paediatric patient care. Medication errors intercepted by pharmacists included over- and under-dosing, missed doses, medication history gaps, allergies, and near-misses. Interventions to address these errors were positively received, and implemented by physicians, with an average acceptance rate of over 95%. Clinical pharmacist-initiated education resulted in improved medication understanding and adherence, improved patient satisfaction, and control of chronic medical conditions.Conclusion: This review found that clinical pharmacists in paediatric wards may reduce drug-related problems and improve patient outcomes. The benefits of pharmacist involvement appear greatest when directly involved in ward rounds, due to being able to more rapidly identify medication errors during the prescribing phase, and provide real-time advice and recommendations to prescribers. What is Known: • Complex paediatric conditions can require multiple pharmaceutical treatments, utilised in a safe manner to ensure good patient outcomes • The benefits of pharmacist interventions when using these treatments are well-documented in adult patients, though less so in paediatric patients What is New: • Pharmacists are adept at identifying and managing medication errors for paediatric patients, including incorrect doses, missed doses, and gaps in medication history • Interventions recommended by pharmacists are generally well-accepted by prescribing physicians, especially when recommendations can be made during the prescribing phase of treatment.
临床药师为成年患者提供有益的服务，但其为儿科住院患者带来的益处则不太明确。本研究检索了五个数据库，使用了 MeSH 术语“临床药师”、“儿科/儿科”、“医院”和“干预”，以寻找在医院环境中针对儿科患者进行的研究，并描述了药师发起的干预措施，这些研究发表于 2000 年 1 月至 2017 年 10 月之间。经过全文审查的搜索策略确定了符合入选标准的 12 篇文章。使用 Joanna Briggs 研究所的质量评估清单对合格文章进行评估。临床药师服务对儿科患者护理有积极影响。药师发现的药物错误包括剂量过大或过小、漏服、药物史空白、过敏和险些发生。这些错误的干预措施得到了积极的回应，并得到了医生的实施，平均接受率超过 95%。临床药师发起的教育使患者对药物的理解和依从性得到提高，提高了患者的满意度，并控制了慢性疾病。结论：本综述发现，儿科病房的临床药师可能会减少与药物相关的问题并改善患者的治疗结果。药师参与的好处在直接参与病房查房时最大，因为他们能够在处方阶段更快地发现药物错误，并为处方医生提供实时的建议和推荐。已知情况：• 复杂的儿科疾病可能需要多种药物治疗，以安全的方式使用，以确保良好的治疗结果。• 药师在使用这些治疗方法时干预的益处已在成年患者中得到充分证实，但在儿科患者中则较少。新情况：• 药师擅长识别和管理儿科患者的药物错误，包括剂量错误、漏服和药物史空白。• 药师建议的干预措施通常得到处方医生的广泛接受，尤其是在治疗的处方阶段可以提出建议时。
