英文阅读 | 药师巧干预，糖尿病人多受益
临床药师参与住院糖尿病患者的查房和药物治疗管理，有助于识别并预防药物相关问题，从而改善患者预后、提升用药安全并可能降低医疗成本。
关键要点
- 在151例住院糖尿病患者中，临床药师共发现189个药物相关问题，其中多数为中度严重程度。
- 最常见的药物相关问题是‘无适应证用药’（18%），其次是‘药物选择不当’（超过16%）。
- 药师提出的干预建议中，30%涉及停用不必要药物（去处方化），医生采纳率约为60%。
- 61至70岁患者药物相关问题更常见，提示老年糖尿病患者需更谨慎的药物管理。
- 将临床药师纳入医护团队可有效提升糖尿病住院患者的药物治疗质量与安全性。
小白老师说：**The researchers concluded that at their facility, including clinical pharmacists on the health care team during ward rounds helped identify and prevent drug-related problems in hospitalized patients with diabetes.
Diabetes Patients Benefit From Pharmacist Intervention
Jeannette Y. Wick, RPh, MBA, FASCP
Published Online: Tuesday, December 15, 2015
Diabetes has a tremendous global impact, but developing nations often struggle to help patients deal with their disease.
Proper drug selection—that is, selecting the drug most likely to improve control and least likely to cause interactions or adherence problems—could change patients’ futures and health care systems’ costs.
A team of pharmacists recently assessed the impact of clinical pharmacist interventions in drug therapy in hospitalized patients with diabetes.
The prospective interventional study took place at a tertiary care teaching hospital over 10 months.
These pharmacists used inpatient case records and attended ward rounds while reviewing drug therapy to identify drug-related problems and discuss potential medication modifications with physicians. They documented all interventions and discussion.
Among 151 patient case records, pharmacists found 189 drug therapy problems. Furthermore, most drug-related problems were graded as moderately significant.
Men tended to have more drug-related problems than women did. This finding was inconsistent with many, but not all, similar studies.
Drug-related problems were considered common in patients aged 61 to 70 years, suggesting that these problems may increase as patients grow older.
The most common drug-related problem was drug use without indication (18%).
Improper drug selection was the second most common problem, with more than 16% of patients affected.
Clinical pharmacists recommended deprescribing specific drugs most often, with 30% of interventions falling into this category.
Physicians were receptive to drug therapy recommendations from pharmacists, implementing about 60% of them.
The researchers concluded that at their facility, including clinical pharmacists on the health care team during ward rounds helped identify and prevent drug-related problems in hospitalized patients with diabetes.
They anticipated that greater pharmacist involvement will decrease costs, improve patient outcomes, and increase overall safety.
This article appeared in Diabetes and Metabolic Syndrome: Clinical Research and Reviews.
常见问题
临床药师如何帮助住院糖尿病患者？
临床药师通过参与查房、审核用药记录，识别如无适应证用药或药物选择不当等问题，并向医生提出调整建议，约60%的建议被采纳。
糖尿病患者中最常见的药物相关问题是什么？
研究显示，最常见的药物相关问题是‘无适应证用药’（占18%），其次是‘药物选择不当’（超过16%）。
哪些年龄段的糖尿病患者更容易出现药物相关问题？
61至70岁的住院糖尿病患者药物相关问题最为常见，提示随年龄增长，用药风险可能上升。
医生是否接受药师的用药建议？
是的，研究中医生采纳了约60%的药师干预建议，表明跨专业协作具有可行性与实效性。
参考资料
Diabetes Patients Benefit From Pharmacist Intervention
作者：Jeannette Y. Wick, RPh, MBA, FASCP；发表于《Diabetes and Metabolic Syndrome: Clinical Research and Reviews》，2015年12月15日。