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药剂师干预对心血管手术中质子泵抑制剂静脉给药转换为口服给药治疗的影响。

The impact of pharmacist intervention on the intravenous-to-oral switch therapy of proton pump inhibitors in cardiovascular surgery.

作者信息

Bao Jianan, Zhou Ling, Xu Mengying, Ma Jingjing

机构信息

Department of Pharmacy, Medical Center of Soochow University, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China.

Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

出版信息

Expert Opin Drug Saf. 2023 Jul-Dec;22(7):611-619. doi: 10.1080/14740338.2023.2172162. Epub 2023 Feb 2.

Abstract

BACKGROUND

The prescriptions of proton pump inhibitors (PPIs) have been widely concerned due to both huge increase in medical costs and possible long-term adverse events (AEs) caused by the improper route of drug administration. The aim of this study was to assess the effectiveness of pharmacist interventions on the clinical outcome and safety of switching from intravenous (IV) to oral PPIs therapy.

PATIENTS AND METHODS

A retrospective, single-center, pre- intervention (early -stage)- and intervention (later -stage) study was performed in a Chinese hospital.

RESULTS

A total of 1736 patients were included in the study. After 12 months of interventions, significant improvements in the number of rational IV to oral switch in patients with oral switch indications were found. The median duration of oral therapy was increased, while the duration of PPIs therapy was decreased. Pharmacist interventions led to significant reductions in mean PPI costs, mean total drug costs, mean hospitalization costs, and the risk for long-term adverse events.

CONCLUSION

This study provides important evidence on the beneficial effect of pharmacist interventions on promoting an optimal IV to oral switch of PPIs and substantial cost saving by shortening the duration of IV PPIs therapy and reducing the risk for long-term AEs.

摘要

背景

质子泵抑制剂(PPIs)的处方因医疗成本大幅增加以及药物给药途径不当可能导致的长期不良事件(AEs)而受到广泛关注。本研究的目的是评估药师干预对从静脉注射(IV)转换为口服PPIs治疗的临床结局和安全性的有效性。

患者与方法

在中国一家医院进行了一项回顾性、单中心、干预前(早期)和干预(后期)研究。

结果

本研究共纳入1736例患者。经过12个月的干预,发现有口服转换指征的患者从静脉注射合理转换为口服的人数有显著改善。口服治疗的中位持续时间增加,而PPIs治疗的持续时间减少。药师干预导致平均PPI成本、平均总药物成本、平均住院成本以及长期不良事件风险显著降低。

结论

本研究提供了重要证据,证明药师干预对促进PPIs从静脉注射到口服的最佳转换具有有益作用,并通过缩短静脉注射PPIs治疗的持续时间和降低长期AEs风险实现了大量成本节约。

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