多学科协作联合医院药师干预在提高内科辅助用药合理管控的作用分析

郑敏 邓灵芝

摘  要：目的  基于多學科协作联合医院药师干预模式，探讨该模式在提高内科辅助用药管理中的应用价值。方法  分析2019年山东省枣庄市肿瘤医院收治的内科患者的辅助用药资料，其中2019年1月～2019年6月纳入的患者资料180例为对照组，实施医院常规的辅助用药管理干预，2019年7月～2019年12月纳入的患者资料200例为研究组，实施多学科协作和医院药师综合干预模式开展辅助用药管理。比较干预前后患者的不良反应发生率、辅助用药不合理情况。结果  干预前，内科辅助用药注射剂不合理使用率高达64.44%（116/180），不良反应发生率21.11%;干预后，患者的无适应症用药、超剂量或疗程用药、联用不合理、未注意用药禁忌证用药率明显下降，不合理使用率低至12.50%（25/200），不良反应发生率达5.00%，差异均有统计学意义（P<0.05）。第三、四季度的无适应证用药、超剂量或疗程用药、联用不合理、未注意用药禁忌证用药率均明显低于第一、二季度（P<0.05）。结论  多学科协作联合医院药师干预的管理模式能有效改善医师的处方质量，在辅助用药管理中起到积极的规范医师处方行为的作用，该管理模式建议临床应用。

关键词：多学科协作;临床药师干预;内科辅助用药

中图分类号：R969.3    文献标识码：A    文章编号：1009-8011（2021）-3-0017-04

Abstract： Objective  Based on the multidisciplinary collaborative hospital pharmacist intervention model， the application value of this model in improving the management of internal medicine auxiliary medication is explored. Methods  Analyze the adjuvant medication data of internal medicine patients admitted to Zaozhuang Cancer Hospital in Shandong Province in 2019. Among them， 180 patients included from January 2019 to June 2019 were the control group， and the hospital's routine adjuvant medication management intervention was implemented， July 2019 From January to December 2019， 200 cases of patient data were included in the research group， and multidisciplinary collaboration and comprehensive intervention mode of hospital pharmacists were implemented to carry out auxiliary medication management. The incidence of adverse reactions and unreasonable adjuvant medications of patients before and after intervention were compared. Results  Before the intervention， the unreasonable use rate of internal medicine injections was as high as 64.44%（116/180）， and the incidence of adverse reactions was 21.11%; after the intervention， the patients' medication without indications， overdose or course of medication， unreasonable combined use， and carelessness The rate of medication contraindications decreased significantly， the rate of irrational use was as low as 12.50%（25/200）， and the incidence of adverse reactions reached 5.00%. The difference was statistically significant（P<0.05）. In the third and fourth quarters， the rate of non-indication medication， overdose or course medication， unreasonable combination use， and inadvertent medication contraindications were significantly lower than in the first and second quarters（P<0.05）. Conclusion  The management model of pharmacist intervention in multidisciplinary cooperative hospitals can effectively improve the quality of physicians' prescriptions， and play an active role in regulating physicians' prescription behavior in the management of auxiliary medications. This management model is recommended for clinical application.

Keywords： multidisciplinary cooperation; clinical pharmacist intervention; internal medicine auxiliary medication

随着我国辅助药物种类的日益丰富，临床药物的不合理使用也日益突出。分析医院药师干预对提高辅助用药合理性的效果。如果发生严重的不良反应，将直接影响患者的耐受性和生活质量。目前，辅助药物的合理性越来越受到人们的关注。据相关调查研究[1]，因不合理用药死亡人数为4.75%。不合理用药已成为危害人类健康的重大隐患。医院药师干预意味着药剂师直接参与治疗，并进行有针对性的评论和培训根据存在的问题在临床药物治疗，以提高临床医生的安全用药意识，提高辅助药物使用的合理性，增强治疗效果，降低药物引起的不良反应，具有重要的临床意义[2-3]。……