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[重症监护医学中基于病房的临床药师:一项经济学评估]

[Ward-based clinical pharmacists in intensive care medicine: an economic evaluation].

作者信息

Liebing Nadja, Ziehr Benjamin, Röber Susanne, Nibbe Lutz, Oppert Michael, Warnke Ulrich

机构信息

Apotheke, Klinikum Ernst von Bergmann gGmbH, Charlottenstr. 72, 14467, Potsdam, Deutschland.

Zentrum für Notfall- und Internistische Intensivmedizin, Klinikum Ernst von Bergmann gGmbH, Potsdam, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2024 Oct;119(7):558-563. doi: 10.1007/s00063-023-01102-y. Epub 2024 Jan 23.

Abstract

BACKGROUND

The positive impact of pharmaceutical care in improving medication safety is considered proven. Little is known about the economic benefit of clinical pharmaceutical services in Germany.

OBJECTIVE

In 2020, a pilot project was started at the Ernst von Bergmann Hospital to introduce ward-based clinical pharmacists in intensive care medicine, also in order to determine the economic benefit of the medication management offered.

METHODS

By a team of experienced intensive care physicians and clinical pharmacists on the basis of a consensus principle, each pharmaceutical intervention (PI) was assigned a probability score (Nesbit probability score) with which an adverse drug event (ADE) would have occurred. Assuming that each ADE results in an increased length of stay, the costs of intensive care treatment/day were used as potential savings. The model thereby combines the findings of two international publications to enable an economic analysis of pharmaceutical services.

RESULTS

During the study period, 177 pharmaceutical interventions were evaluated and corresponding probability scores for the occurrence of ADE were determined. From this, annual savings of € 80,000 through avoided costs were calculated.

CONCLUSION

In this project, the economic benefit of pharmaceutical services in intensive care medicine was proven. Ward-based clinical pharmacists are now an integral part of the intensive care treatment team at the Ernst von Bergmann Hospital.

摘要

背景

药学服务在提高用药安全性方面的积极影响被认为已得到证实。在德国,临床药学服务的经济效益鲜为人知。

目的

2020年,恩斯特·冯·伯格曼医院启动了一个试点项目,引入重症医学科的病房临床药师,也是为了确定所提供药物管理的经济效益。

方法

由一组经验丰富的重症医学医师和临床药师根据共识原则,为每一项药学干预(PI)赋予一个不良药物事件(ADE)发生的概率评分(内斯比特概率评分)。假设每一次ADE都会导致住院时间延长,将重症监护治疗每天的费用用作潜在节省费用。该模型由此结合了两篇国际出版物的研究结果,以便对药学服务进行经济分析。

结果

在研究期间,评估了177项药学干预,并确定了ADE发生的相应概率评分。据此计算出通过避免成本每年节省80,000欧元。

结论

在该项目中,重症医学中药学服务的经济效益得到了证实。病房临床药师现已成为恩斯特·冯·伯格曼医院重症监护治疗团队不可或缺的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cb6/11461657/6a6f8071ffff/63_2023_1102_Fig1_HTML.jpg

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