如何优化儿科放射性药物处方的药物分析？
How can we optimise the pharmaceutical analysis of radiopharmaceutical pediatric prescriptions?
机构信息
Radio-Pharmacology, Institut Curie, PSL Research University, Paris, France.
Pharmacy and Sterilization Department, AP-HP Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicetre, Île-de-France, France.
出版信息
Eur J Hosp Pharm. 2023 Jan;30(1):29-34. doi: 10.1136/ejhpharm-2020-002473. Epub 2021 May 7.
OBJECTIVES
In France, dispensation is defined by the validation of a prescription associated with a pharmaceutical analysis, preparation of medication and provision of information necessary for proper use. There are very few data available in the literature that describe prescription analysis modality in radiopharmacy. The aim was to secure a place for paediatric prescription analysis in radiopharmacy by designing a flow chart validated by experts.
METHODS
Experts from different disciplines and health setups (ie, public, private) were selected to represent the various paediatric patient care processes. A review of the literature on pharmaceutical analysis and paediatric prescription in radiopharmacy was conducted. A Delphi approach comprising two rounds (Google Form survey) was used to validate the flow chart. Answers were graded according to a nine-point Likert scale for agreement. Open-ended questions allowed experts to comment on the propositions. A consensus between experts was reached if more than 70% of the experts agreed on an item and fewer than 30% disagreed.
RESULTS
Sixty-five experts were solicited: two oncopaediatricians, three nuclear medicine physicians, 46 radiopharmacists, three residents in radiopharmacy, one hospital pharmacist, five medical physicists, one pharmacy technician, two X-ray technicians and two patients who are pharmacists. The first round survey included a draft of the flow chart: 31 experts answered (48%). All professional disciplines were represented except pharmacy technician. The second round survey was sent with a new flow chart that had been improved by the experts' comments. After 3 weeks, 18 answers were obtained (28%). After the first round, consensus was obtained for each item. Experts gave a total of 97 comments. The second flow chart had three steps: regulatory aspects, patient data, and radiopharmaceutical data, and it was accompanied by descriptive text explaining the field of application.
CONCLUSION
The resulting flow chart will secure the pharmaceutical analysis step for this special patient population.
目的
在法国，配药是指对处方进行验证，包括药物分析、药物制备以及提供正确使用所需的信息。文献中很少有数据描述放射药学中的处方分析模式。本研究旨在通过设计一个经专家验证的流程图，为儿科处方分析在放射药学中的应用提供依据。
方法
从不同学科和医疗环境（即公共、私人）中选择专家来代表各种儿科患者的护理流程。对放射药学中的药物分析和儿科处方进行文献复习。采用两轮德尔菲法（Google 表单调查）来验证流程图。答案按照九点李克特量表进行评分，以表示同意程度。开放问题允许专家对建议进行评论。如果超过 70%的专家同意某一项，而少于 30%的专家不同意，则达成专家共识。
结果
共征求了 65 名专家的意见：2 名肿瘤儿科医生、3 名核医学医生、46 名放射药剂师、3 名放射药学住院医师、1 名医院药剂师、5 名医学物理学家、1 名药剂技术员、2 名 X 光技术员和 2 名药剂师患者。第一轮调查包括流程图草案：31 名专家回答（48%）。除了药剂技术员外，所有专业学科都有代表。第二轮调查发送了一份经过专家评论改进的新流程图，3 周后收到 18 份回复（28%）。第一轮后，每个项目都达成了共识。专家共提出了 97 条意见。第二张流程图有三个步骤：监管方面、患者数据和放射药物数据，并附有说明应用领域的描述性文字。
结论
生成的流程图将确保为这一特殊患者群体提供药物分析步骤。
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