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[引入门诊癌症药物治疗的患者基准绩效衡量(PBPM)的效果及其对医生工作量的影响]

[Effects of Introducing PBPM for Outpatient Cancer Drug Therapy and Its Impact on Physician Workload].

作者信息

Yanagawa Toshinori, Kataoka Kozo, Yamashita Noriko, Yanai Mina, Tanaka Kuniyoshi, Bando Junko, Fukuda Tomoko, Miyazaki Mikiko, Ogata Fumihiro, Hirayama Miyu, Tanaka Arina, Hirata Mayumi, Demachi Tomoko, Ikeda Masataka, Kimura Takeshi

机构信息

Dept. of Pharmacy, Hyogo Medical University Hospital.

出版信息

Gan To Kagaku Ryoho. 2024 Jul;51(7):747-751.

Abstract

In May 2022, Hyogo Medical University Hospital introduced protocol-based pharmacotherapy management(PBPM), which is jointly planned by doctors and pharmacists, for certain cancer drug therapies. Colorectal cancer patients who underwent outpatient cancer chemotherapy in the Department of Lower Gastrointestinal Surgery from October to December 2021(before the introduction of PBPM)and from May to August 2022(after the introduction of PBPM)were retrospectively studied. The proportion of clinical examinations performed, number of prescription questions, and time taken by pharmacists to solve the prescription questions before and after the introduction of PBPM were compared. Additionally, the number of modifications made in the medical record by pharmacists on behalf of doctors in response to the prescription questions was assessed. The proportion of clinical examinations performed(clinical examinations actually performed/clinical examinations that should have been performed)improved from 93.2%(260/279)before to 98.8%(405/410)after the introduction of PBPM(p<0.001). The number of prescription questions decreased from an average of 64.7(±11.9)per month before to an average of 29.5(±3.4)per month after the introduction of PBPM. The average number of modifications made in the medical record by pharmacists on behalf of the doctors in response to the prescription questions was 25.8(±5.4)per month after the introduction of PBPM. There was no significant difference before and after the introduction of PBPM in regard to the median(interquartile range)time taken by pharmacists to solve the prescription questions (before PBPM: 1.88 minutes per case[1.70-2.28 minutes]; after PBPM: 1.71 minutes per case[1.61-2.06 minutes][p= 0.75]). The increased proportion of clinical examinations performed after the implementation of PBPM may have improved the safety of cancer drug management, and the decreased number of prescription questions is speculated to have led to a reduction in physician workload.

摘要

2022年5月,兵库医科大学附属医院针对某些癌症药物治疗引入了由医生和药剂师共同规划的基于协议的药物治疗管理(PBPM)。对2021年10月至12月(引入PBPM之前)以及2022年5月至8月(引入PBPM之后)在下消化道外科门诊接受癌症化疗的结直肠癌患者进行了回顾性研究。比较了引入PBPM前后进行临床检查的比例、处方问题数量以及药剂师解决处方问题所花费的时间。此外,还评估了药剂师代表医生针对处方问题在病历中所做修改的数量。引入PBPM后,进行临床检查的比例(实际进行的临床检查/应进行的临床检查)从之前的93.2%(260/279)提高到了98.8%(405/410)(p<0.001)。处方问题数量从引入PBPM之前的平均每月64.7(±11.9)个减少到了之后的平均每月29.5(±3.4)个。引入PBPM后,药剂师代表医生针对处方问题在病历中所做修改的平均数量为每月25.8(±5.4)处。引入PBPM前后,药剂师解决处方问题的中位(四分位间距)时间没有显著差异(引入PBPM之前:每例1.88分钟[1.70 - 2.28分钟];引入PBPM之后:每例1.71分钟[1.61 - 2.06分钟][p = 0.75])。实施PBPM后临床检查比例的提高可能改善了癌症药物管理的安全性,并且推测处方问题数量的减少导致了医生工作量的降低。

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