Department of Pharmacy, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.
Department of Pharmacy, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences; Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application (Beijing Hospital), Beijing, 100730, China.
BMC Health Serv Res. 2022 Dec 6;22(1):1483. doi: 10.1186/s12913-022-08897-0.
Inadequate preoperative management of chronic medications can place perioperative patients at risk and cause unnecessary delays in surgical procedures. This study aims to investigate the prevalence of chronic medication therapy problems (CMTPs) in hospitalized perioperative patients and assess the relevance of pharmacists' interventions.
We conducted a retrospective study of pharmacist-led preoperative management of chronic medications in hospitalized adult patients from November 2018 to April 2019. The recorded drug-related problems (DRPs) were retrospectively reviewed and categorized according to the Pharmaceutical Care Network Europe classification V9.1 and were analyzed with a multinomial regression model to identify risk factors.
A total of 254 DRPs were recorded, with an average of 0.52 DRPs per patient. Treatment safety (66.9%) was the most common DRP. The most frequent causes of perioperative DRPs and nonperioperative DRPs were drug selection (72.9%) and patient related (50.8%), respectively. Of the 292 documented interventions, 71.6% were fully accepted by the clinicians and patients. The majority (68.9%) of the recorded problems were completely resolved. The number of comorbidities (OR = 3.815) and the number of chronic medications taken (OR = 1.539) were risk factors for the occurrence of DRPs.
The findings of this study suggest that pharmacist-led chronic medication therapy management in surgical wards may be an effective method to help reduce medication-related surgical risks and optimize the medication therapies used for the long-term treatment of chronic diseases.
慢性药物治疗管理不足会使围手术期患者面临风险，并导致手术程序不必要的延迟。本研究旨在调查住院围手术期患者中慢性药物治疗问题（CMTP）的发生率，并评估药师干预的相关性。
我们对 2018 年 11 月至 2019 年 4 月期间药师主导的住院成年患者慢性药物术前管理进行了回顾性研究。对记录的药物相关问题（DRP）进行回顾性审查，并根据欧洲药物治疗管理网络分类 V9.1 进行分类，采用多项回归模型分析识别危险因素。
共记录了 254 个 DRP，每个患者平均有 0.52 个 DRP。治疗安全性（66.9%）是最常见的 DRP。围手术期和非围手术期 DRP 最常见的原因分别是药物选择（72.9%）和患者相关（50.8%）。在 292 项记录的干预措施中，71.6%得到临床医生和患者的完全接受。记录的问题中有 68.9%得到了完全解决。合并症数量（OR=3.815）和服用的慢性药物数量（OR=1.539）是发生 DRP 的危险因素。
本研究结果表明，外科病房中由药师主导的慢性药物治疗管理可能是一种有效方法，有助于降低与药物相关的手术风险，并优化用于长期治疗慢性疾病的药物治疗。
