Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
J Clin Pharm Ther. 2021 Feb;46(1):149-157. doi: 10.1111/jcpt.13273. Epub 2020 Oct 5.
At present, studies on the usage of proton-pump inhibitors (PPIs) have universal significance. In clinical practice, PPIs are widely used to treat a variety of acid-related diseases, but they can be inappropriately prescribed, leading to increased medical costs and patient harm. The study comprehensively evaluated the clinical effects of a clinical pharmacist intervention on inappropriate PPI prescriptions in a tertiary general hospital hepatobiliary surgery ward.
A retrospective, single-centre intervention study covering the periods of July-December 2018 and July-December 2019 was conducted. In the intervention group, clinical pharmaceutical care was initiated by a clinical pharmacist in the hepatobiliary surgery ward. Outcomes, including the clinical pattern of PPI utilization, the rate of inappropriate PPI use and safety outcomes, were compared between the two periods.
In total, 1150 patients were admitted to the hepatobiliary surgery ward in our hospital in the study periods. Of these, 717 patients met the inclusion criteria for this study, and 420 and 297 patients were included in the preintervention and post-intervention groups, respectively. The PPI utilization rates before and after the intervention were 82.0% and 55.0%, respectively. The rates of inappropriate PPI use before and after the intervention were 48.9 and 22.7 per 100 patient-days, respectively. Clinical safety outcomes were nearly identical between before and after the intervention, but patients treated with PPIs were more likely to experience nosocomial pneumonia (2.4% vs. 0.6%).
The implementation of a clinical pharmacist intervention for PPI use decreased inappropriate PPI use during hospitalization without sacrificing clinical safety outcomes.
目前，质子泵抑制剂（PPIs）的使用研究具有普遍意义。在临床实践中，PPIs 被广泛用于治疗各种酸相关疾病，但可能会被不恰当地开具，导致医疗费用增加和患者伤害。本研究全面评估了临床药师干预对三级综合医院肝胆外科病房中 PPI 不合理处方的临床效果。
采用回顾性、单中心干预研究，涵盖 2018 年 7 月至 12 月和 2019 年 7 月至 12 月两个时期。在干预组中，临床药师在肝胆外科病房启动临床药学服务。比较两个时期的 PPI 使用临床模式、不合理 PPI 使用率和安全性结果。
共有 1150 名患者在研究期间入住我院肝胆外科病房。其中，717 名患者符合本研究纳入标准，420 名和 297 名患者分别纳入干预前和干预后组。干预前后 PPI 使用率分别为 82.0%和 55.0%。干预前后不合理 PPI 使用率分别为 48.9 和 22.7/100 患者日。干预前后临床安全性结果几乎相同，但使用 PPI 的患者更有可能发生医院获得性肺炎（2.4%比 0.6%）。
实施临床药师干预 PPI 使用可减少住院期间不合理 PPI 使用，而不影响临床安全性结果。
