CAJ | 학술논문

目的：：探索临床药师参与临床治疗团队，对医嘱用药合理率的影响。方法：将我院2011年1~12月高血压及高血压伴发1~3种疾病的782份病历作为干预前组；2012年9月~2013年8月高血压及高血压伴发1~3种疾病的1061份病历作为干预后组。将两组病历均划分为8个疾病亚组，临床药师对干预后组病历医嘱进行及时干预后，比较干预前后病历的医嘱用药合理率数据。结果：高血压、高血压伴发冠心病、高血压伴发心力衰竭、高血压伴发糖尿病疾病亚组，干预前后的医嘱用药合理率差异均有统计学意义(P<0.01)；高血压伴发冠心病及心力衰竭、高血压伴发冠心病及糖尿病、高血压伴发心力衰竭及糖尿病疾病亚组，干预前后的医嘱用药合理率的差异均有统计学意义(P<0.05)；高血压伴发冠心病及心力衰竭及糖尿病疾病亚组干预前后的医嘱用药合理率差异无统计学意义(P>0.05)。8个疾病亚组病历汇总后比较干预前后医嘱合理率，差异有统计学意义(P<0.01)。结论：临床药师参与临床治疗，通过对不合理用药医嘱的干预，可提高临床医师的医嘱合理性，尽可能地规避医疗风险，保证患者用药的安全有效性。
목적：：탐색림상약사삼여림상치료단대，대의촉용약합리솔적영향。방법：장아원2011년1~12월고혈압급고혈압반발1~3충질병적782빈병력작위간예전조；2012년9월~2013년8월고혈압급고혈압반발1~3충질병적1061빈병력작위간예후조。장량조병력균화분위8개질병아조，림상약사대간예후조병력의촉진행급시간예후，비교간예전후병력적의촉용약합리솔수거。결과：고혈압、고혈압반발관심병、고혈압반발심력쇠갈、고혈압반발당뇨병질병아조，간예전후적의촉용약합리솔차이균유통계학의의(P<0.01)；고혈압반발관심병급심력쇠갈、고혈압반발관심병급당뇨병、고혈압반발심력쇠갈급당뇨병질병아조，간예전후적의촉용약합리솔적차이균유통계학의의(P<0.05)；고혈압반발관심병급심력쇠갈급당뇨병질병아조간예전후적의촉용약합리솔차이무통계학의의(P>0.05)。8개질병아조병력회총후비교간예전후의촉합리솔，차이유통계학의의(P<0.01)。결론：림상약사삼여림상치료，통과대불합리용약의촉적간예，가제고림상의사적의촉합이성，진가능지규피의료풍험，보증환자용약적안전유효성。
Objective:To explore the impact of clinical pharmacists involved in the treatment team on the reasonable drug use rate in medical orders. Methods:Totally 782 medical records including hypertension and 1-3 kinds of hypertension associated diseases in our hospital from January 2011 to December 2011 were used as the pre-intervention group, and 1 061 ones with the same conditions from September 2012 to August 2013 were used as the post-intervention group. The patients of the two groups were divided into 8 dis-ease subgroups, clinical pharmacists performed timely intervention on the medical orders in the post-intervention group, and the rational drug use rate between the two groups was compared. Results:In hypertension, hypertension associated coronary heart disease, hyper-tension with heart failure and hypertension with diabetes subgroups,the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 01), in hypertension with coronary heart disease and heart failure, hypertension associ-ated coronary heart disease and diabetes, hypertension with heart failure and diabetes subgroup, the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 05), while in hypertension with coronary heart disease, heart failure and diabetes subgroups, the difference was not statistically significant(P>0. 05). After the medical records in the 8 sub-groups were aggregated, the difference in the rational drug use proportion before and after the intervention was statistically significant( P<0. 01). Conclusion:Clinical pharmacists should involve in the clinical treatment to intervene irrational drug use,which can signifi-cantly improve the medical record rationality, avoid the health risks as much as possible and ensure the medication safety and treatment effectiveness for patients.