Page 122 - 《中国药房》2024年3期

·药师与药学服务·

基于化疗相关问题建立药学监护路径
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陈 雅 ，杨婷蓉，赵 华，王 莹（贵航贵阳医院药学部，贵阳 550009）
＊

中图分类号 R95；R979.1 文献标志码 A 文章编号 1001-0408（2024）03-0368-06
DOI 10.6039/j.issn.1001-0408.2024.03.18

摘 要 目的 设计化疗相关问题药学监护路径并评估其是否有助于发现并干预化疗患者的药物相关问题（DRPs）。方法 通过
药学监护实践经验建立并实施化疗相关问题药学监护路径表与流程图。将该药学监护路径实施前后入住我院接受化疗的患者分
为对照组（实施前，60例）与观察组（实施后，64例），提取对照组患者相关病历用以评估DRPs，对观察组患者进行化疗相关问题药
学监护并提取DRPs。比较两组患者的基本情况、化疗情况、DRPs类别与干预情况、化疗所致不良反应、DRPs的欧洲医药保健网
（PCNE）分类、DRPs发生时间、DRPs涉及的药物类别。结果 两组患者的基本情况、化疗方案与化疗药物类别比较，差异均无统计
学意义（P＞0.05）。对照组与观察组分别有46、37例患者发生DRPs。两组DRPs均主要发生在化疗期间，且主要为化疗前期。利
用化疗相关问题药学监护路径，DRPs 的识别率从对照组的 52.17% 显著提高至观察组的 91.89%（P＜0.05），干预率从对照组的
32.61%显著提高至观察组的72.97%（P＜0.05），不良反应发生率从对照组的28.33%显著降低至观察组的12.50%（P＜0.05）。对
照组DRPs的主要问题类型为治疗有效性，主要涉及药物为辅助抗肿瘤药，主要发生原因为超适应证给予辅助抗肿瘤药；观察组
DRPs的主要问题类型为治疗有效性和治疗安全性，主要涉及药物为止吐药，主要发生原因为预防化疗所致恶心呕吐用药不足。
结论 化疗相关问题药学监护路径的实施有助于临床药师更好地识别与干预化疗患者的DRPs，减少化疗所致不良反应的发生。
关键词 药学监护路径；临床药师；药学监护；化疗相关问题

Establishment of pharmaceutical care pathway based on the problems related to chemotherapy
CHEN Ya，YANG Tingrong，ZHAO Hua，WANG Ying（Dept. of Pharmacy， Guihang Guiyang Hospital， Guiyang
550009， China）

ABSTRACT OBJECTIVE To design pharmaceutical care pathway for the problems related to chemotherapy， and to evaluate
whether it contributes to the detection and intervention of drug-related problems （DRPs） in chemotherapy patients. METHODS The
pharmaceutical care pathway table and flow charts were constructed and implemented by pharmaceutical care practice experience.
The patients who were admitted to our hospital for chemotherapy before and after the implementation of the pharmaceutical care
pathway were divided into control group （before the implementation，60 cases） and observation group （after the implementation，64
cases）， respectively； the relevant medical records of patients in the control group were extracted to evaluate DRPs， and
pharmaceutical care of chemotherapy-related problems was performed for patients in observation group to extract DRPs. The basic
condition， chemotherapy condition， DRPs classification and intervention status， adverse reactions induced by chemotherapy， PCNE
classification of DRPs， occurrence time of DRPs， and drug classes related to DRPs were compared between 2 groups. RESULTS
There was no statistical significance in the basic situation， chemotherapy regimen and chemotherapy drug category between the two
groups （P＞0.05）. DRPs occurred in 46 and 37 patients in control group and observation group， respectively. In both groups，
DRPs mainly occurred during chemotherapy， and mainly in the early stage of chemotherapy. Using the new pathway， the detection
of DRPs significantly increased from 52.17% in the control group to 91.89% in the observation group （P＜0.05）. The successful
intervention rate of DRPs was significantly increased from 32.61% in the control group to 72.97% in the observation group （P＜
0.05）. The incidence of adverse drug reactions significantly decreased from 28.33% in the control group to 12.50% in the
observation group（P＜0.05）. The main problem type of DRPs in the control group was treatment effectiveness， which mainly
involved adjuvant antitumor drugs， mainly due to the use of adjuvant anti-tumor drugs for off-label prescribing； that of the
observation group was treatment effectiveness and treatment safety， which mainly involved vomiting drugs， mainly due to
insufficient medication to prevent nausea and vomiting caused by chemotherapy. CONCLUSIONS The implementation of the
pathway helps clinical pharmacists to detect and intervene in DRPs among chemotherapy patients， and reduces the occurrence of
chemotherapy-induced adverse reactions.
Δ 基金项目 通用医疗科研基金项目（No.TYYLKYJJ-2022-037）
＊第一作者 主管药师，硕士。研究方向：临床药学。E-mail： KEYWORDS pharmaceutical care pathway； clinical phar-
635959626@qq.com macist； pharmaceutical care； chemotherapy-related problems

· 368 · China Pharmacy 2024 Vol. 35 No. 3 中国药房 2024年第35卷第3期