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药剂师管理的肿瘤门诊对解决门诊肿瘤患者药物相关问题的影响:中国的一项前瞻性研究。

Impacts of Pharmacists-Managed Oncology Outpatient Clinic on Resolving Drug-Related Problems in Ambulatory Neoplasm Patients: A Prospective Study in China.

机构信息

Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

Inquiry. 2021 Jan-Dec;58:469580211009662. doi: 10.1177/00469580211009662.

Abstract

Pharmacists are health care professionals who are actively involved in identifying and solving drug-related problems (DRPs) in neoplasm patients. However, the effectiveness of pharmaceutical services at outpatient clinic for neoplasm patients have not been reported in China. This study aims to describe and investigate the impacts of pharmacists-managed oncology outpatient clinic on ambulatory neoplasm patients. We performed a descriptive, prospective study from June 6, 2018 to June 6, 2020. Firstly, we established a pharmacists-managed oncology outpatient clinic and a Pharmacists Work System of Medication Therapy Management (MTM) software with the cooperation of oncologists, pharmacists and software engineers in 2018. Subjects were neoplasm patients who visited the pharmacists-managed outpatient clinic. The pharmacists performed a comprehensive assessment of the patient's medication and made planned interventions based on the DRPs identified. A total of 215 eligible patients with 707 visits were enrolled and recorded in the MTM software. A total of 316 DRPs (1.47 per patient) were identified. Adverse reactions, non-adherence, untreated indication, and drug interactions were the leading DRPs. 261 (82.6%) of the identified DRPs had been confirmed as resolved and 104 (78.2%) of adverse reactions were improved following pharmacist interventions and 2 to 3 course follow-up. Of the 382 planned interventions, 345 (90.3%) were accepted by patients or physicians. This is the first pharmacists-managed oncology outpatient clinic to describe the type of DRPs in neoplasm patients and evaluate the effectiveness of pharmacist interventions in China. Pharmacist interventions were efficacious in resolving DRPs and improving adverse reactions. We confirmed that pharmacists have an important role in ambulatory neoplasm patients care.

摘要

药剂师是积极参与识别和解决肿瘤患者药物相关问题(DRPs)的医疗保健专业人员。然而,中国尚未报道门诊肿瘤患者的药学服务效果。本研究旨在描述和调查药剂师管理的肿瘤门诊对门诊肿瘤患者的影响。我们于 2018 年 6 月 6 日至 2020 年 6 月 6 日进行了一项描述性、前瞻性研究。首先,我们与肿瘤学家、药剂师和软件工程师合作,于 2018 年建立了药剂师管理的肿瘤门诊和药剂师药物治疗管理(MTM)软件的工作系统。研究对象为访问药剂师管理门诊的肿瘤患者。药剂师对患者的用药情况进行全面评估,并根据识别出的 DRPs 进行有计划的干预。共纳入并记录在 MTM 软件中的 215 名符合条件的患者,共 707 次就诊。共发现 316 项 DRPs(每位患者 1.47 项)。不良反应、不依从、未治疗的指征和药物相互作用是主要的 DRPs。已确认解决了 261 项(82.6%)已识别的 DRPs,104 项(78.2%)不良反应在药剂师干预和 2 至 3 个疗程的随访后得到改善。在 382 项计划干预中,有 345 项(90.3%)被患者或医生接受。这是第一个描述中国肿瘤患者 DRPs 类型并评估药剂师干预效果的药剂师管理的肿瘤门诊。药剂师干预在解决 DRPs 和改善不良反应方面是有效的。我们证实,药剂师在门诊肿瘤患者护理中发挥着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e389/8047945/d7feb8ca2a4d/10.1177_00469580211009662-fig1.jpg

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