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[德国重症监护病房中重症监护医师与临床药师跨专业合作对药物治疗安全性的支持:一项调查结果]

[Drug therapy safety supported by interprofessional collaboration between ICU physicians and clinical pharmacists in critical care units in Germany : Results of a survey].

作者信息

Hilgarth Heike, Waydhas Christian, Dörje Frank, Sommer Julia, Kluge Stefan, Ittner Karl Peter

机构信息

Klinikapotheke und Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.

Ausschuss für Intensivmedizin und klinische Ernährung, ADKA - Bundesverband Deutscher Krankenhausapotheker e. V., Berlin, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2023 Mar;118(2):141-148. doi: 10.1007/s00063-022-00898-5. Epub 2022 Mar 8.

DOI:10.1007/s00063-022-00898-5
PMID:35258694
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9992023/
Abstract

BACKGROUND

Critically ill patients are particularly susceptible to adverse drug events. International studies show that pharmaceutical care has a positive impact on patient and drug therapy safety. Nationally, the integration of pharmacists into the multidisciplinary team and participation in ward rounds is required. The aim of this work is to assess the scope and extent of pharmaceutical care in intensive care units (ICU) in Germany.

METHOD

In a literature and database search, 13 relevant pharmaceutical activities were identified. Based on this, an online survey with 27 questions on the implementation of pharmaceutical care in ICU was prepared by a panel of experts. The survey was sent to heads of German ICUs.

RESULTS

Of the participants, 35.3% (59/167) have established regular pharmaceutical care. Drug information (89.7% [52/58]), pharmaceutical interventions with change of therapy (e.g., ward rounds; 67,2% [39/58]), regular evaluation of prescriptions (medication analysis; 65.5% [38/58]) as well as the monitoring of medication (e.g., side effects, effectiveness, costs; 63.8% [37/58]) were most frequently mentioned. The participants with pharmaceutical care (58/168) graded 7 of 13 but those without (104/168) only two  activities as 'essential/indispensable'.

CONCLUSION

Only a few ICU in Germany have already integrated ward pharmacists into the multidisciplinary team. Once a pharmaceutical service has been established, a greater role/importance is assigned to several pharmaceutical activities.

摘要

背景

重症患者尤其容易发生药物不良事件。国际研究表明,药学服务对患者和药物治疗安全有积极影响。在国内,需要将药剂师纳入多学科团队并参与查房。这项工作的目的是评估德国重症监护病房(ICU)药学服务的范围和程度。

方法

通过文献和数据库检索,确定了13项相关药学活动。在此基础上,一个专家小组编制了一项关于ICU药学服务实施情况的包含27个问题的在线调查。该调查发送给了德国ICU的负责人。

结果

在参与者中,35.3%(59/167)已经建立了常规药学服务。最常提到的是药物信息(89.7%[52/58])、改变治疗方案的药学干预(如查房;67.2%[39/58])、处方的定期评估(用药分析;65.5%[38/58])以及药物监测(如副作用、疗效、成本;63.8%[37/58])。有药学服务的参与者(58/168)将13项活动中的7项评为“基本/不可或缺”,而没有药学服务的参与者(104/168)仅将两项活动评为“基本/不可或缺”。

结论

德国只有少数ICU已经将病房药剂师纳入多学科团队。一旦建立了药学服务,多项药学活动将被赋予更大的作用/重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/468e/9992023/ed032265dcd6/63_2022_898_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/468e/9992023/4109e0ba8094/63_2022_898_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/468e/9992023/ed032265dcd6/63_2022_898_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/468e/9992023/4109e0ba8094/63_2022_898_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/468e/9992023/ed032265dcd6/63_2022_898_Fig2_HTML.jpg

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本文引用的文献

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Eur J Hosp Pharm. 2021 Nov;28(6):301-305. doi: 10.1136/ejhpharm-2019-001973. Epub 2019 Aug 23.
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Characterizing Critical Care Pharmacy Services Across the United States.美国重症监护药学服务的特征分析
Crit Care Explor. 2021 Jan 8;3(1):e0323. doi: 10.1097/CCE.0000000000000323. eCollection 2021 Jan.
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Position Paper on Critical Care Pharmacy Services: 2020 Update.危重病药学服务立场文件:2020 年更新版。
[重症监护医学中基于病房的临床药师:一项经济学评估]
Med Klin Intensivmed Notfmed. 2024 Oct;119(7):558-563. doi: 10.1007/s00063-023-01102-y. Epub 2024 Jan 23.
4
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J Clin Med. 2023 Jul 18;12(14):4739. doi: 10.3390/jcm12144739.
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[Standardized concentrations for continuous infusion-results of a nationwide survey in German intensive care units].[持续输注的标准化浓度——德国重症监护病房全国性调查结果]
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