摘要
目的:探讨中药临床药师在骨科中医临床路径的制定与实施中发挥的作用和效果。方法:选择2009~2011年入组桡骨骨折临床路径的患者60例作为对照组,2015~2016年桡骨骨折患者54例作为观察组,观察组实施的中医临床路径由中药临床药师与医师共同制定,并全程由中药临床药师进行药学监护。对比两组临床疗效并通过观察两组中药的合理使用率、平均住院时间、平均中药费用和药品不良反应(ADR)发生率的变化,评价中药临床药师参与临床路径制定与实施的效果。结果:中药临床药师参与中医临床路径制定和实施后,较参与前患者的治疗总有效率由80.0%提高至92.6%,中药合理使用率由60.0%提高至85.2%(P<0.05);平均住院时间由(14.0±2.3)d缩短至(11.0±3.1)d,平均中药费用由(887.07±186.44)元降低至(437.14±127.32)元(P<0.05);ADR发生率由16.7%下降至11.1%。结论:中药临床药师在临床路径的制定与实施中发挥了重要的作用,通过中药临床药师的参与,可明显促进患者安全、有效、合理和经济用药,有利于缩短患者住院时间,减少住院费用。
Objective： To explore the effects of Chinese medicine clinical pharmacists participating in the formulation and imple- mentation of traditional Chinese medicine clinical pathway in orthopaedics department. Methods： Totally 60 cases of radius fracture patients were selected from 2009 to 2011 as the control group, and 54 cases of radius fracture patients were selected as the observation group in our hospital during 2015 and 2016. The observation group was instructed by both Chinese medicine clinical pharmacists and doctors; meanwhile, Chinese medicine clinical pharmacists were responsible for the entire pharmaceutical care. The clinical curative effect of the two groups, the rational use rate of traditional Chinese medicines, the average length of stay, the average cost of traditional Chinese medicines and the incidence of ADR between the groups were compared. The effect of Chinese medicine clinical pharmacists participating in the formulation and implementation of clinical pathway was evaluated. Results ： After the formulation and implementa- tion of clinical pathway, the total effective rate was improved from 80.0% to 92.6%, the rational use rate of traditional Chinese medi- cines increased significantly from 60.0% to 85.2%, and the differences were statistically significant （P 〈 0.05）. The average length of stay decreased significantly from （ 14.0 ＋ 2.3 ） d to （ 11.0 -＋ 3.1 ） d and the diffet＇ent;e was statistically significant （ P 〈 0.05 ）. Meanwhile, the average cost of traditional Chinese medicines decreased from （887.07 ＋ 186.44） yuan to （437.14 ＋ 127.32） yuan and the difference was statistically significant （P 〈 0.05 ）. Moreover, the incidence of ADR decreased from 16.7% to 11.1%. Conclusion： Chinese medicine clinical pharmacists should participate in the whole process of clinical pathway, which can play an important role in ensuring the implementation of clinical pathway and standardizing the rational drug use. It can significantly make the clinical medication safer,and more effective and economical. It can shorten the hospital stay and reduce the hospitalization costs as well.
出处
《中国药师》
CAS
2017年第12期2180-2182,2189,共4页
China Pharmacist
基金
国家中医药管理局课题项目[编号:SATCM-2015-XXBZ[064]]
关键词
中药临床药师
桡骨骨折
中医临床路径
合理用药
Chinese medicine clinical pharmacists
Radius fractures
Traditional Chinese medicine clinical pathway
Rational drug use
