药剂师主导的血管外科手术患者干预措施：一项关于减少药物相关问题的前瞻性研究。

Pharmacist-led interventions for vascular surgery patients: a prospective study on reducing drug-related problems.

作者信息

Porubcova Slavka, Szmicsekova Kristina, Lajtmanova Kristina, Slezakova Veronika, Jakubik Michal, Drobna Eva, Tomka Jan, Kobliskova Zuzana, Masarykova Lucia, Lehocka Lubica, Tesar Tomas

机构信息

Hospital Pharmacy, The National Institute of Cardiovascular Diseases, Bratislava, Slovakia.

Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia.

出版信息

BMC Health Serv Res. 2024 Dec 18;24(1):1564. doi: 10.1186/s12913-024-12015-7.

DOI:10.1186/s12913-024-12015-7

PMID:39695586

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11653549/

Abstract

BACKGROUND

Vascular surgery patients are at a high risk of polypharmacy and drug-related problems. Only a limited number of studies have explored the impact of hospital pharmacists being members of a multidisciplinary team in the care of vascular surgery patients. The clinical study (Trial Registration Number NCT04930302, 16 June 2021) aimed to assess the impact of pharmacist-led interventions on the prevalence of drug-related problems among patients hospitalised at the vascular surgery department.

METHODS

The study, conducted at a specialised hospital in Slovakia during a 1-year period, included adult patients with carotid artery disease or lower extremity artery disease, taking ≥3 medications. Medication reconciliation and medication reviews were performed by hospital pharmacists at both admission and discharge. Pharmacist-proposed interventions were documented and communicated to the physician, patients were educated about their medications upon discharge.

RESULTS

Among our study participants (n = 105), the average number of drug-related problems at admission was 2.3 ± 2.1, significantly decreasing to 1.6 ± 1.8 at discharge (p < 0.001). The predominant drug classes associated with drug-related problems were those related to the cardiovascular system (41.9%). At admission, the most frequent drug-related problem was untreated indication (40.3%), mostly caused by the failure to prescribe statin in patients with lower extremity artery disease. The highest acceptance rate of pharmacist-led interventions was at hospital admission (66.1%). More than 50% of patients were classified as those with good understanding of their pharmacotherapy.

CONCLUSIONS

This study demonstrates that pharmacist-led interventions significantly reduce drug-related problems in vascular surgery patients during hospitalisation, contributing to patient safety and clinical outcomes.

TRIAL REGISTRATION

ClinicalTrials.gov Trial Registration Number: NCT04930302, 16 June 2021.

摘要

背景

血管外科患者存在多种药物联合使用及药物相关问题的高风险。仅有有限的研究探讨了医院药师作为多学科团队成员在血管外科患者护理中的影响。这项临床研究（试验注册号NCT04930302，2021年6月16日）旨在评估药师主导的干预措施对血管外科住院患者药物相关问题发生率的影响。

方法

该研究在斯洛伐克的一家专科医院进行，为期1年，纳入患有颈动脉疾病或下肢动脉疾病且服用≥3种药物的成年患者。医院药师在入院和出院时均进行了用药核对和用药审查。记录药师提出的干预措施并传达给医生，患者出院时接受了用药教育。

结果

在我们的研究参与者（n = 105）中，入院时药物相关问题的平均数量为2.3±2.1，出院时显著降至1.6±1.8（p < 0.001）。与药物相关问题相关的主要药物类别是心血管系统药物（41.9%）。入院时，最常见的药物相关问题是未治疗的适应症（40.3%），主要是由于下肢动脉疾病患者未开具他汀类药物。药师主导的干预措施在入院时的接受率最高（66.1%）。超过50%的患者被归类为对药物治疗有良好理解的患者。