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评估药师干预癌症疼痛患者药物相关问题和药物费用的效果。

Evaluation of pharmacists' interventions on drug-related problems and drug costs in patients with cancer pain.

机构信息

Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, People's Republic of China.

Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Western New England University, 1215 Wilbraham Road, Springfeld, MA, 01119, USA.

出版信息

Int J Clin Pharm. 2021 Oct;43(5):1274-1282. doi: 10.1007/s11096-021-01247-w. Epub 2021 Feb 24.

Abstract

BACKGROUND

Drug-related problems (DRPs) prevent patients from fully benefiting from drug treatment. Unrelieved pain in patients with cancer is still widespread. Pharmacists can play a role in closely monitoring cancer patients, pain control maintenance, and patient consultation.

OBJECTIVE

To evaluate the clinical effects and changes in drug costs of pharmacists' interventions on patients with DRPs related to cancer pain.

SETTING

An academic teaching hospital in Shanghai, China.

METHODS

Patients with cancer pain admitted to Shanghai Tongren Hospital from October 2018 to February 2019 were randomized into the intervention and control groups. The Pharmaceutical Care Network Europe classification V8.02 was used to categorize DRPs treated with analgesics. Patients' pain relief, the occurrence of adverse drug reactions, and drug cost-saving through the resolution of DRPs were evaluated.

MAIN OUTCOME MEASURE

Problems and causes of drug-related problems, interventions proposed, and outcome of pharmacy recommendations.

RESULTS

A total of 172 patients were enrolled and randomized into the intervention group (n = 86) and the control group (n = 86). The pharmacist detected 66 DRPs in 48 patients (55.8%) of the intervention group, an average of 0.8 DRPs per patient. A total of 149 interventions were proposed by the pharmacist. Compared to the control group, the drug intervention produced more pain relief on the third day of analgesic treatment. In the intervention group, a total of 33 DRP interventions resulted in cost changes, saving a drug cost of $489.90, averaging $11.94 per intervention.

CONCLUSION

Our study suggests that pharmacy service in patients with cancer pain can resolve drug-related problems and reduce drug costs.

摘要

背景

药物相关问题(DRPs)会妨碍患者充分受益于药物治疗。癌症患者的疼痛未得到缓解的情况仍很普遍。药剂师可以在密切监测癌症患者、维持疼痛控制和患者咨询方面发挥作用。

目的

评估药剂师干预癌症相关疼痛患者 DRPs 对患者的临床效果和药物成本变化。

设置

中国上海的一家学术教学医院。

方法

2018 年 10 月至 2019 年 2 月期间,将上海同仁医院收治的癌症疼痛患者随机分为干预组和对照组。采用欧洲药品管理局药物相关问题分类 V8.02 对使用镇痛药治疗的 DRPs 进行分类。评估患者疼痛缓解情况、不良反应发生情况以及通过解决 DRPs 节省的药物成本。

主要观察指标

药物相关问题的问题和原因、提出的干预措施以及药房建议的结果。

结果

共纳入 172 例患者,随机分为干预组(n=86)和对照组(n=86)。药师在干预组 48 例(55.8%)患者中发现 66 例 DRPs,平均每位患者 0.8 例 DRPs。药师共提出 149 项干预措施。与对照组相比,药物干预在使用镇痛药治疗的第 3 天能带来更明显的疼痛缓解。在干预组中,共有 33 项 DRP 干预措施导致药物成本发生变化,节省了 489.90 美元的药物成本,平均每次干预节省 11.94 美元。

结论

本研究表明,癌症疼痛患者的药学服务可以解决药物相关问题并降低药物成本。

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