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·药师与药学服务·
儿童罕见病多学科诊疗的药学服务模式探索
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黄 亮 1, 2, 3* ,王其琼 ,陈 力 ,俞 丹 ,吴 瑾 ,林芸竹 ,曾力楠 ,贾知军 1, 2, 3 ,成 果 2, 4, 5 ,张伶俐 1, 2 #
(1.四川大学华西第二医院药学部/循证药学中心/国家药品监督管理局药物制剂体内外相关性技术研究重点实
验室,成都 610041;2.出生缺陷与相关妇儿疾病教育部重点实验室,成都 610041;3.四川大学华西药学院,
成都 610041;4.四川大学华西第二医院儿科,成都 610041;5.四川大学转化医学中心分子转化医学实验室,
成都 610041)
中图分类号 R952 文献标志码 A 文章编号 1001-0408(2023)08-1000-05
DOI 10.6039/j.issn.1001-0408.2023.08.20
摘 要 目的 探索儿童罕见病多学科诊疗(MDT)的药学服务模式。方法 四川大学华西第二医院(以下简称“我院”)临床药师
参与儿童罕见病MDT过程,通过基于循证实践制定药物治疗方案,提高治疗药物可及性,药学监护,药物治疗管理,全程参与患儿
诊疗过程,构建儿童罕见病MDT的药学服务模式。结果 2021年1月-2022年4月,我院临床药师共累计参与39例罕见病患儿的
MDT,包括罕见病住院患儿21例,罕见病门诊患儿18例,共涉及23种罕见病;完成罕见病住院患儿药学查房45例次、药学会诊26
例次,罕见病门诊患儿MDT讨论25例次、药学门诊5例次,院内外罕见病患儿用药教育38例次,院外患儿随访25例次。有24例
(61.54%)患儿涉及超说明书用药,涉及13种罕见病和16种治疗药品,其中11种药品已完成或正在进行超说明书用药备案;3种药
品完成临时采购药品审核评估;完成医保药品和高值药品处方审核268例次。结论 我院初步建立了儿童罕见病MDT“院内+院
外、线上+线下”的闭环药学服务模式,该模式提高了我院儿童罕见病治疗药物的院内可及性、临床应用的规范性及儿童罕见病的
诊疗水平。
关键词 儿童;罕见病;多学科诊疗;临床药师;药学服务
Exploration of pharmaceutical service model in multidisciplinary diagnosis and treatment of rare diseases
in children
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HUANG Liang 1, 2, 3 ,WANG Qiqiong ,CHEN Li ,YU Dan ,WU Jin ,LIN Yunzhu ,ZENG Linan ,JIA
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Zhijun 1, 2, 3 ,CHENG Guo 2, 4, 5 ,ZHANG Lingli (1. Dept. of Pharmacy/Evidence-Based Pharmacy Center/NMPA
Key Laboratory for Technical Research on Drug Products in vitro and in vivo Correlation, West China Second
University Hospital, Sichuan University, Chengdu 610041, China;2. Key Laboratory of Birth Defects and
Related Diseases of Women and Children of Ministry of Education, Chengdu 610041,China;3. West China
School of Pharmacy, Sichuan University, Chengdu 610041, China;4. Dept. of Pediatrics, West China Second
Hospital, Sichuan University, Chengdu 610041, China;5. Laboratory of Molecular Translational Medicine,
Center for Translational Medicine, Sichuan University,Chengdu 610041, China)
ABSTRACT OBJECTIVE To explore the pharmaceutical service model in multidisciplinary diagnosis and treatment (MDT) of
rare diseases in children. METHODS Clinical pharmacists of West China Second University Hospital (hereinafter referred to as
“our hospital”) participated in the process of MDT of children’s rare diseases. Clinical pharmacists took part in the entire diagnosis
and treatment process of children and established the MDT pharmaceutical service model of children’s rare diseases by formulating
drug treatment plans based on evidence-based practice, improving the accessibility of drugs, pharmaceutical monitoring and drug
treatment management. RESULTS From January 2021 to April
Δ 基金项目 四川省科技计划项目(No.2020YFS0035) 2022, clinical pharmacists of our hospital had participated in a
*第一作者 副主任药师,硕士。研究方向:循证临床药学、药物治 total of 39 cases of rare diseases MDT in children, including
疗的药动学基础。电话:028-85503057。E-mail:hliang_1022@163.
21 hospitalized children with rare diseases and 18 outpatient
com
children with rare diseases, involving a total of 23 rare
# 通信作者 主任药师,博士生导师,博士。研究方向:循证药物决
策与管理、循证临床药学研究与实践。电话:028-85503205。E-mail: diseases. Clinical pharmacists completed 45 pharmaceutical
zhanglingli@scu.edu.cn rounds and 26 pharmaceutical consultations for rare diseases
· 1000 · China Pharmacy 2023 Vol. 34 No. 8 中国药房 2023年第34卷第8期