Chen Qiying, Wang Qiaohong, Zhang Yin
Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Pharmacy, QuanZhou Women's and Children's Hospital, Quanzhou, China.
Front Pharmacol. 2022 Apr 25;13:864081. doi: 10.3389/fphar.2022.864081. eCollection 2022.
This study aimed to evaluate the role of the clinical pharmacist in the rational use of proton pump inhibitors (PPIs) in a general surgery department. All enrolled patients had attended the general surgery department of a tertiary hospital. This single-center prospective study compared differences in the overall rate of rational PPI use, proportion of unindicated PPI use, utilization rate, average defined daily dose (DDD), drug costs, PPI costs, and cost-effectiveness of clinical pharmacist intervention between the intervention (538 cases) and control (536 cases) groups. In the intervention group, Pareto and fishbone diagram analyses were combined with the Plan-Do-Check-Act cycle; Statistical Package for the Social Sciences was used for analyzing all data. The overall rate of rational PPI use was significantly higher in the intervention group than in the control group ( < 0.01). The proportion of unindicated PPI use, utilization rate, average DDD, drug costs, and PPI costs were significantly lower in the intervention group than in the control group ( < 0.05). Cost-effectiveness analysis for the overall rate of rational PPI use indicated a positive impact of intervention, with economic benefits in the intervention group. Clinical pharmacist intervention for rational use of PPIs in general surgery departments could significantly increase the overall rate of rational PPI use; it could also reduce the proportion of unindicated PPI use, utilization rates, average DDDs, drug costs, and PPIs costs. Pharmacist intervention also offers economic benefits by improving the overall rate of rational PPI use.
本研究旨在评估临床药师在普通外科合理使用质子泵抑制剂（PPI）中的作用。所有纳入的患者均就诊于一家三级医院的普通外科。这项单中心前瞻性研究比较了干预组（538例）和对照组（536例）之间PPI合理使用的总体率、无指征使用PPI的比例、利用率、平均限定日剂量（DDD）、药品费用、PPI费用以及临床药师干预的成本效益的差异。在干预组中，将帕累托图和鱼骨图分析与计划-执行-检查-行动循环相结合；使用社会科学统计软件包分析所有数据。干预组PPI合理使用的总体率显著高于对照组（<0.01）。干预组无指征使用PPI的比例、利用率、平均DDD、药品费用和PPI费用均显著低于对照组（<0.05）。对PPI合理使用总体率的成本效益分析表明干预具有积极影响，干预组有经济效益。临床药师对普通外科合理使用PPI的干预可显著提高PPI合理使用的总体率；还可降低无指征使用PPI的比例、利用率、平均DDD、药品费用和PPI费用。药师干预通过提高PPI合理使用的总体率也带来了经济效益。
