Page 115 - 《中国药房》2023年12期

·药师与药学服务·

药师参与多学科诊疗的模式探讨及效果评价
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1， 3 #
李 赟 1， 2＊ ，王立新 ，郭 阳 ，田 杰 ，刘 芳 （1.北京大学第三医院药剂科，北京 100191；2.山西医科大
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2
2
学第一医院药学部，太原 030001；3.北京大学医学部药品评价中心，北京 100191）
中图分类号 R95 文献标志码 A 文章编号 1001-0408（2023）12-1515-05
DOI 10.6039/j.issn.1001-0408.2023.12.20

摘 要 目的 评价药师参与多学科诊疗（MDT）的模式及效果。方法 计算机检索Cochrane图书馆、PubMed、Embase、中国知网、
中国生物医学文献数据库和万方数据，收集药师参与MDT对患者临床结局影响的试验性研究和观察性研究。提取资料和评价质
量后，对纳入研究的结果进行描述性分析。结果 共纳入10项研究，其中3项研究为随机对照试验（RCT），2项研究为非RCT，4项
研究为队列研究，1项研究为病例对照研究；共计2 422例患者。有效性方面，药师参与MDT后患者的肿瘤无进展生存期、糖化血
红蛋白、再入院率和住院时间等指标均显著改善。安全性方面，药师参与MDT后患者大出血事件发生率显著降低。经济性方面，
药师参与MDT后患者与药物相关的住院费用、平均门诊医疗费用总额均显著改善，但医疗费用未见明显改善。人文结局方面，药
师参与MDT后患者的依从性结论存在争议。结论 药师根据自身的药学服务技能和方法，全程化地参与MDT，改善了患者的临
床结局，提高了用药的安全性，但在经济性和人文结局方面尚存在争议。
关键词 药师；多学科诊疗；系统评价；参与模式；效果

Investigation of the mode of pharmacist participating in multi-disciplinary diagnosis and treatment and
effect evaluation
LI Yun ，WANG Lixin ，GUO Yang ，TIAN Jie ，LIU Fang （1. Dept. of Pharmacy， the Third Hospital of
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1， 2
2
1， 3
Peking University， Beijing 100191， China；2. Dept. of Pharmacy， the First Hospital of Shanxi Medical
University， Taiyuan 030001， China；3. Drug Evaluation Center， Peking University Health Science Center，
Beijing 100191， China）
ABSTRACT OBJECTIVE To evaluate the mode of pharmacists’ participation in multi-disciplinary diagnosis and treatment
（MDT）， as well as the effects of pharmacists’ participation. METHODS Retrieved from Cochrane Library， PubMed， Embase，
CNKI， CBM and Wanfang database， experimental studies and observational studies on the effects of MDT with pharmacists on
clinical outcomes of patients were collected. After data extraction and quality evaluation， the results of included studies were
analyzed descriptively. RESULTS A total of 10 studies were included， among which 3 were randomized controlled trials （RCT）， 2
were non-RCT， 4 were cohort and 1 was case-control study； there were 2 422 patients in total. In terms of effectiveness， tumor
progression-free survival， glycosylated hemoglobin， re-admission rate and length of stay and other indexes were all improved
significantly after pharmacists participated in MDT. In terms of safety， the incidence of major bleeding events was significantly
decreased after pharmacists participated in MDT. In terms of economy， hospitalization costs and total outpatient expenses were
improved significantly after pharmacists participated in MDT， but medical cost was not improved significantly. In terms of
humanistic outcomes， there was controversy over the conclusion of patient compliance after pharmacists participated in MDT.
CONCLUSIONS Pharmacists， based on their own pharmaceutical care skills and methods， actively participate in MDT throughout
the process， improving the clinical outcomes of patients and enhancing the safety of medication. There are still controversies
regarding economic and humanistic outcomes.
KEYWORDS pharmacist； multi-disciplinary treatment； systematic review； participation mode； effectiveness

Δ 基金项目 首都卫生发展科研专项项目（No.首发2020-1-2031） 多学科诊疗（multi-disciplinary treatment，MDT）是
＊第一作者 副主任药师，硕士。研究方向：临床药学、医院药学。 指由多学科专家针对某一种或某一系统疾病的患者进
E-mail：103734502@qq.com
行讨论，在综合各学科意见的基础上为患者制定最佳治
# 通信作者 主任药师，硕士。研究方向：临床药学、循证药学。电
话：010-82266682。E-mail：liufang8-111@163.com 疗方案的治疗模式 [1—2] 。不同的MDT可根据团队成员的

中国药房 2023年第34卷第12期 China Pharmacy 2023 Vol. 34 No. 12 · 1515 ·