药剂师干预教会病人的药物相关问题风险倡导者

M. K. Setiawati, Nanang Munif Yasin, I. Pramantara
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摘要

老年患者患药物相关问题(DRPs)的风险很高,这些问题与衰老过程引起的多发病、生理变化和药理学改变有关。药剂师在优化患者药物治疗的有效性和安全性方面发挥着重要作用。本研究旨在了解药剂师干预在降低DRPs有害水平方面的效果,并了解住院老年患者中与降低DRPs危害水平相关的因素。本研究采用准实验研究,采用一组前测和后测设计。这项研究于2021年3月至4月在Panti Rapih医院进行,患者的纳入标准为≥60岁,有内科疾病病例,并在治疗中确定了DRP。排除患者的标准是在重症监护室和新冠肺炎病房住院。药剂师审查了患者的药物治疗,确定并解决了DRP。比较药剂师干预前后DRPs的危害程度。DRP的危害程度是根据药物错误分类工具通过专业调整确定的,然后使用Wilcoxon检验进行分析,置信度为95%。使用多变量逻辑回归测试,研究了年龄、患者接受的药物数量、合并症和干预接受度等因素对降低DRP危害水平的影响。研究对象共有28名住院患者,确定了47名DRP。最常见的DRP是药物不良反应(27.6%)。在所有干预措施中,77.36%的干预措施被接受并得到充分实施。药剂师的干预导致潜在和实际DRP的危害水平显著降低(p<0.05)。患者接受的药物数量和药剂师干预的接受程度与DRP危害水平的降低有关(p<0.05)。这项研究表明,在老年患者的护理中需要多学科合作。
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Pengaruh Intervensi Apoteker terhadap Tingkat Bahaya Drug-Related Problems pada Pasien Geriatrik Rawat Inap
Geriatric patients are at high risk of Drug-Related Problems (DRPs) associated with multimorbidity, physiologic changes, and pharmacologic alterations, that caused by the aging process. The pharmacist plays an important role in optimizing the effectiveness and safety of the patient’s drug therapies. This study aims to know the effect of pharmacist intervention in reducing the harmful levels of DRPs and to know the factors associated with the reduction of DRPs harm level in hospitalized geriatric patients. This research uses quasi-experimental study with a one-group pretest and posttest design. This research was conducted in Panti Rapih Hospital between March-April 2021, with patients’ inclusion criteria of ≥ 60 years old, with internal diseases cases, and identified DRPs in the therapy. The exclusion patient criteria are hospitalized in the intensive unit and Covid-19 ward. A pharmacist reviewed patient drug therapy, identified and solved DRPs. The harm level of DRPs was compared before and after pharmacist interventions. The harm level of DRPs was determined through professional adjustment according to The Harm Associated with Medication Error Classification tools, then analyzed using Wilcoxon test with a level of confidence 95%. Factors of age, the number of drugs received by the patient, comorbidities, and acceptance of the intervention were investigated for their effect on reducing the harm level of DRPs using a multivariate logistic regression test. A total of the research subject were 28 inpatients, with 47 DRPs identified. The most frequent DRPs were adverse drug reactions  (27,66%). Among all interventions, 77,36% of them were accepted with full implementation. The pharmacist intervention resulted in a significant reduction in the harm level of both potential and actual DRPs (p < 0,05). A factor of the number of drugs received by patients and acceptance of pharmacist intervention was associated with the reduction of the harm level of DRPs (p < 0,05). This study shows that multidisciplinary collaboration is needed in the care of geriatric patients.
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