Zhou Xin, Qiu Feng, Wan Dong, Sun Shusen, Yao Gaoqiong, Liu Yu, Li Juan
Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Asia Pac J Clin Nutr. 2019;28(2):246-251. doi: 10.6133/apjcn.201906_28(2).0006.
The participation of a nutrition support pharmacist (NSP) in a multidisciplinary team (MDT) for patients receiving nutrition support therapy (NST) may lead to more favourable outcomes and fewer complications and adverse events. However, few studies have demonstrated the role of NSPs in MDTs in China. To investigate pharmacy interventions and physician acceptance of these interventions for patients receiving NST in an intensive care unit (ICU).
A prospective study over a 12-month period was conducted in an ICU at an academic hospital in China. Interventions were documented and divided into the following categories: indication of NST, parenteral nutrition (PN) prescription and delivery, enteral nutrition (EN) route and formulation, fluids and electrolytes, laboratory test monitoring, nutritional supplements, and other medication-related problems. Data regarding the intervention categories, timing, acceptance rates, and methods of communication to discuss pharmacy interventions were collected.
In total, 247 interventions for 120 patients were identified. The overall acceptance rate of interventions was 85.0% (210/247), and more than half of the interventions (143, 57.9%) were performed during daily follow-up. The most common intervention categories were PN prescription and delivery (81/247, 32.8%), EN route and formula (33/247, 13.4%), indication of NST (33/247, 13.4%), and nutritional supplements (30/247, 12.1%). The most accepted intervention category was PN prescription and delivery (79/81, 97.5%), and the most common method of communication was oral communication during MDT rounds (201/247, 81.4%).
This study demonstrated the unique perspectives offered and importance of having pharmacists as members of MDTs.
营养支持药师（NSP）参与多学科团队（MDT）为接受营养支持治疗（NST）的患者服务，可能会带来更有利的结果，减少并发症和不良事件。然而，在中国，很少有研究证明NSP在MDT中的作用。本研究旨在调查在中国一家学术医院的重症监护病房（ICU）中，针对接受NST的患者，药学干预措施以及医生对这些干预措施的接受情况。
在中国一家学术医院的ICU进行了一项为期12个月的前瞻性研究。记录干预措施并分为以下几类：NST的指征、肠外营养（PN）的处方与实施、肠内营养（EN）的途径与配方、液体与电解质、实验室检查监测、营养补充剂以及其他与药物相关的问题。收集有关干预类别、时间、接受率以及讨论药学干预措施的沟通方法的数据。
共识别出针对120例患者的247项干预措施。干预措施的总体接受率为85.0%（210/247），超过一半的干预措施（143项，57.9%）是在日常随访期间实施的。最常见的干预类别是PN的处方与实施（81/247，32.8%）、EN的途径与配方（33/247，13.4%）、NST的指征（33/247，13.4%）以及营养补充剂（30/247，12.1%）。最被接受的干预类别是PN的处方与实施（79/81，97.5%），最常见的沟通方式是在MDT查房期间进行口头沟通（201/247，81.4%）。
本研究证明了药师作为MDT成员所提供的独特视角及其重要性。
