Winter M E, Herfindal E T, Bernstein L R
Am J Hosp Pharm. 1986 Sep;43(9):2178-84.
The effects of pharmacokinetics consultation by a pharmacist on the quality of drug therapy were studied in a 500-bed teaching hospital. Data were collected retrospectively for three time periods: three months before, four months during, and three months after a period of intervention by a pharmacist with special responsibilities for pharmacokinetic monitoring of patients on a medical team. For the four-month intervention period, data were also collected for a parallel group of patients managed by another medical team that included pharmacy residents and students. Patients were included in the study if they had received either an aminoglycoside or a theophylline preparation. The preintervention, postintervention, and parallel groups were random samples of patients on the study ward, and the intervention group included all patients admitted to the pharmacist intervener's medical team who had received a drug covered by the study. Of serum drug concentration determinations (SDCDs) in the pharmacist intervention phase, 54% were appropriate, compared with 16% before intervention, 21% in the postintervention phase, and 46% in the patients of the other medical team. In the pharmacist intervention group, greater numbers of SDCDs were obtained appropriately and used appropriately in making therapeutic decisions, as evidenced by more subsequent measurements in the therapeutic range. Pharmacist intervention did not affect the number of adverse drug reactions or medical specialty consultations or the average length of stay. Decentralized pharmacokinetics services can have a positive effect on the quality of serum drug concentration determinations, dosage adjustments, and drug therapy.
在一家拥有500张床位的教学医院中，研究了药剂师进行药代动力学咨询对药物治疗质量的影响。回顾性收集了三个时间段的数据：在一名负责医疗团队患者药代动力学监测的药剂师进行干预前三个月、干预期间四个月以及干预后三个月。在四个月的干预期内，还收集了由另一个医疗团队管理的平行患者组的数据，该团队包括药房住院医师和学生。如果患者接受了氨基糖苷类药物或茶碱制剂，则纳入研究。干预前、干预后和平行组是研究病房患者的随机样本，干预组包括药剂师干预者所在医疗团队中所有接受过研究涵盖药物治疗的患者。在药剂师干预阶段，血清药物浓度测定（SDCD）中有54%是合适的，干预前为16%，干预后阶段为21%，另一个医疗团队的患者为46%。在药剂师干预组中，有更多数量的SDCD被适当地获得并用于做出治疗决策，这表现为后续在治疗范围内的测量更多。药剂师干预并未影响药物不良反应的数量、医学专科会诊次数或平均住院时间。分散的药代动力学服务可对血清药物浓度测定、剂量调整和药物治疗质量产生积极影响。
