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[急诊室专科药师对急诊医学的影响]

[Effects of Emergency Room-specialized Pharmacists on Emergency Medicine].

作者信息

Saito Yasuhiro

机构信息

Department of Pharmacy, Sapporo Higashi Tokushukai Hospital.

Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital.

出版信息

Yakugaku Zasshi. 2023;143(8):623-628. doi: 10.1248/yakushi.23-00085.

Abstract

It is difficult to say that pharmacist services in the emergency room (ER) are widespread nationwide. According to a survey of certified emergency pharmacists, the work area they are most commonly engaged in is the intensive care unit. This may be due to the lack of reimbursement for pharmacist services in ERs and the absence of operational guidelines. On the other hand, Sapporo Higashi Tokushukai Hospital has had ER specialized pharmacists (ESPs) since 2016 and has reported on the usefulness of pharmacist services in the ER at conferences and in papers. Among other things, it has been shown that the workload of emergency physicians is reduced by 1.9 h/d through the use of ESPs, and that also contributes to the increase in accurate diagnoses of drug-induced diseases and the treatment of infectious diseases. Reports on the benefits of ESP have also begun to emerge in Japan, including a significant decrease in the number of incident reports. Meanwhile, overseas reports indicate that ESPs have a significant impact on healthcare economics, such as "an annualized cost avoidance effect of more than 400 million yen." Furthermore, reports of improvements in operational guidelines and patient outcomes that support these guidelines indicate that ESPs in other countries are well-established ahead of their counterparts in Japan. We strongly hope that ESPs will increase in number and distribution in Japan in the future through the evaluation of reimbursement and formulation of operational guidelines.

摘要

很难说急诊室的药剂师服务在全国范围内广泛存在。根据一项对认证急诊药剂师的调查,他们最常从事的工作领域是重症监护病房。这可能是由于急诊室药剂师服务缺乏报销以及缺乏操作指南。另一方面,札幌东独协医院自2016年起就有急诊专科药剂师(ESP),并在会议和论文中报告了急诊室药剂师服务的效用。其中,通过使用ESP,急诊医生的工作量每天减少了1.9小时,这也有助于提高药物性疾病的准确诊断率以及传染病的治疗效果。关于ESP益处的报告在日本也开始出现,包括不良事件报告数量显著减少。与此同时,海外报告表明ESP对医疗保健经济学有重大影响,例如“每年节省成本超过4亿日元”。此外,关于操作指南改进以及支持这些指南的患者预后改善的报告表明,其他国家的ESP比日本的同行发展得更成熟。我们强烈希望未来通过报销评估和操作指南的制定,日本的ESP数量和分布能够增加。

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