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通过儿科神经科药物重整提高用药安全性:一项为期13周的研究中临床药师的建议及医生的采纳情况

Improving Medication Safety Through Medication Reconciliation in Pediatric Neurology: Clinical Pharmacist Recommendations and Physician Uptake in a 13-Week Study.

作者信息

Zennaro Margherita, Trotter Anna, Mengato Daniele, Camuffo Laura, Ancona Claudio, Toldo Irene, Giron Maria Cecilia, Pelizza Maria Federica, Nosadini Margherita, Perilongo Giorgio, Sartori Stefano, Venturini Francesca

机构信息

Hospital Pharmacy Department, Azienda Ospedale-Università Padova, Via Giustiniani, 35128 Padua, Italy.

Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy.

出版信息

Children (Basel). 2025 May 12;12(5):625. doi: 10.3390/children12050625.

DOI:10.3390/children12050625
PMID:40426804
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12110433/
Abstract

Clinical pharmacy plays a crucial role in optimizing medication use, particularly in pediatric settings where drug therapy can be complex and understudied. This study aims to assess the impact of clinical pharmacists in the Pediatric Neurology and Neurophysiology Unit of the Padova University Hospital, focusing on physician acceptance of pharmacist suggestions and the types of advice most frequently followed. A retrospective observational study was conducted over 13 weeks to describe the implementation phase of clinical pharmacists' involvement in medication reconciliation in this setting. The study consisted of three steps. The study utilized a cluster model to categorize pharmacist suggestions and to evaluate physician acceptance rates. The study included 57 hospitalized pediatric patients (53% male) with a median age of 3 years (IQR: 1-10.25). A total of 138 recommendations were shared, with an overall acceptance rate of 42%. Medication errors accounted for the largest cluster of suggestions (45%), though only 32% were accepted. Among the most frequently shared categories of suggestions, pharmaceutical form optimization (A) and drug supply (E) exhibited higher acceptance rates by clinicians (64% and 42%, respectively). The acceptance rate increased over time, peaking at 100% during weeks 7 and 11, correlating positively with enhanced collaboration between pharmacists and clinicians (R = 0.59). This study highlights the importance of clinical pharmacists in pediatric care, particularly in improving medication management through targeted interventions. The findings suggest that integrating clinical pharmacists into multidisciplinary teams can enhance patient care quality by fostering collaboration and trust among healthcare professionals.

摘要

临床药学在优化药物使用方面发挥着关键作用,尤其是在儿科环境中,药物治疗可能很复杂且研究不足。本研究旨在评估帕多瓦大学医院儿科神经科和神经生理学部门临床药师的影响,重点关注医生对药师建议的接受情况以及最常被采纳的建议类型。进行了一项为期13周的回顾性观察研究,以描述临床药师参与该环境下药物重整的实施阶段。该研究包括三个步骤。该研究采用聚类模型对药师的建议进行分类,并评估医生的接受率。该研究纳入了57名住院儿科患者(53%为男性),中位年龄为3岁(四分位间距:1 - 10.25岁)。共分享了138条建议,总体接受率为42%。用药错误占建议的最大类别(45%),但仅32%被接受。在最常分享的建议类别中,剂型优化(A)和药品供应(E)的临床医生接受率较高(分别为64%和42%)。接受率随时间增加,在第7周和第11周达到100%的峰值,与药师和临床医生之间加强合作呈正相关(R = 0.59)。本研究强调了临床药师在儿科护理中的重要性,特别是通过有针对性的干预改善用药管理。研究结果表明,将临床药师纳入多学科团队可以通过促进医疗专业人员之间的合作和信任来提高患者护理质量。

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本文引用的文献

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Children (Basel). 2025 Jan 24;12(2):124. doi: 10.3390/children12020124.
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Polypharmacy in Children with Medical Complexity: A Cross-Sectional Study in a Pediatric Palliative Care Center.患有复杂疾病儿童的多重用药情况:一项在儿科姑息治疗中心开展的横断面研究
Children (Basel). 2024 Jul 4;11(7):821. doi: 10.3390/children11070821.
3
Impact of clinical pharmacist-led intervention for drug-related problems in neonatal intensive care unit a randomized controlled trial.
临床药师主导的干预对新生儿重症监护病房药物相关问题的影响:一项随机对照试验
Front Pharmacol. 2023 Aug 14;14:1242779. doi: 10.3389/fphar.2023.1242779. eCollection 2023.
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Implementation and results of a standardized process for identifying ambulatory pharmacy clinical outcome measures.确定门诊药房临床结果测量指标的标准化流程的实施和结果。
Am J Health Syst Pharm. 2023 Jun 22;80(13):860-867. doi: 10.1093/ajhp/zxad056.
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European Society of Clinical Pharmacy definition of the term clinical pharmacy and its relationship to pharmaceutical care: a position paper.欧洲临床药学学会对临床药学术语的定义及其与药学服务的关系:立场文件。
Int J Clin Pharm. 2022 Aug;44(4):837-842. doi: 10.1007/s11096-022-01422-7. Epub 2022 Jun 6.
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Estimated Manipulation of Tablets and Capsules to Meet Dose Requirements for Chinese Children: A Cross-Sectional Study.估计为满足中国儿童剂量需求而对片剂和胶囊进行的调配:一项横断面研究。
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