中国药房2017，Vol.28Issue(32)：4580-4584,5.DOI:10.6039/j.issn.1001-0408.2017.32.31
临床药师开展内科住院患者入院药物重整的药学服务实践
Pharmaceutical Care Practice for Admission Medication Reconciliation in the Internal Medicine Inpatient by Clinical Pharmacists
摘要
Abstract
OBJECTIVE:To explore the importance and necessity of clinical pharmacists in drug therapy for chronic disease patients,the feasibility of developing medication reconciliation (MR),and to provide reference for establishing the internal medicine working model of clinical pharmacy.METHODS:During May to Jul.2016,inpatients were selected from respiratory department of our hospital as subjects.After detailed pharmaceutical consultation,clinical pharmacist conducted MR for newly inpatients at the first day in the hospital.RESULTS:Through clinical pharmacists classified and organized the problems of drug use in the inpatients during medication,MR records of 98 inpatients were collected,involving 296 medical orders and 96 items of medication errors.Among MR patients,there were only 44 cases of good compliance (44.9％);some problems about drug use existed in other cases,including optional medication,improper usage and dosage,fearing of drug side effects and refusing to use drugs,drug withdrawal due to ADR,follow-up failure of special disease leading to excessive or inadequate dose,poor communication with doctors leading to medication errors,forgetting to take medication or missing,excessive medical treatment and so on.Most common medication error-inducing drugs type was cardiovascular drug,followed by respiratory drug and endocrine system drug.CONCLUSIONS:The development of MR by clinical pharmacists is helpful to identify and correct medication error,avoid potential medication error,and control disease.It can be used as a project of pharmaceutical care in department of internal medicine.关键词
临床药师/药物重整/呼吸内科/药学服务/用药差错Key words
Clinical pharmacist/Medication reconciliation/Respiration department/Pharmaceutical care/Medication error分类
医药卫生引用本文复制引用
姚慧娟,李平,刘昕竹,卜书红,张健..临床药师开展内科住院患者入院药物重整的药学服务实践[J].中国药房,2017,28(32):4580-4584,5.基金项目
上海交通大学医学院医院药学科研基金资助项目(No.JDYX2016QN005) （No.JDYX2016QN005）
