某三级教学医院内科药物治疗问题的前瞻性观察研究

Revathi J., V. P, A. C, G. Mohanta, S. M.
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摘要

背景:药物治疗问题(DTP)是指涉及或怀疑涉及药物治疗的患者所经历的任何不良事件,并干扰治疗预期目标的实现。药物使用不当可导致患者发病甚至死亡。DTP是药学护理从业者的临床领域,确定DTP的解决方案有助于患者实现其治疗目标。确定dtp能够量化风险并确定预防战略的潜在影响。dtp与住院时间延长和经济负担增加有关,并导致死亡风险增加。方法:在Rajah Muthiah医学院及医院内科开展以医院为基础的前瞻性观察研究,按纳入-排除标准纳入80例患者。采用Cipolle的DTP分类方法对DTP进行鉴定。结果:研究表明,80例患者共136个dtp。在研究期间,每位患者平均记录了1.7次dtp。最常见的DTP是不必要的药物治疗,占47%。缺乏有效的医学指征(30%)和(16%)是由于重复治疗。第二常见的DTP是对患者不安全的药物,占45%,是由于患者不遵守规定和药物相互作用,这是轻微的。需要额外的药物治疗是确定的第三大原因,占13%是由于医学指征表明需要药物治疗。结论:最常见的DTP是不必要的治疗和患者对药物的不依从性。本研究提示,dtp在医院显著发生可导致患者出现合并症,延长住院时间。建议临床药师与全科医生共同努力,发现并解决dtp问题。
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A study on drug therapy issues in the department of medicine of a tertiary care teaching hospital-prospective observational study
Background: A drug therapy problem (DTP) is any undesirable event experienced by a patient that involves or is suspected to involve, drug therapy, and that interferes with achieving the desired goals of therapy. The improper use of drugs can lead to patient morbidity and even mortality. DTP s are the clinical territory of the pharmaceutical care practitioner and the resolution of identifying the DTPs help patients to achieve their goals of therapy. Identifying DTPs enables risk quantification and determination of the potential impact of prevention strategies.  DTPs are associated with prolonged length of stay and increased economic burden and results in increased risk of death.Methods: A hospital based, prospective observational study was conducted at department of medicine in Rajah Muthiah medical college and hospital, 80 patients were enrolled in this study based on the inclusion-exclusion criteria. The DTPs were identified using the Cipolle’s method of classification of DTP.Results: The study has shown that 80 of the patients involved in the study had a total of 136 DTPs. An average of 1.7 DTPs were recorded per patient during the study. The most common DTP identified was unnecessary drug therapy accounting to 47%. The absence of valid medical indication was (30%) and (16%) were due to the duplication of therapy. The second most common DTP was unsafe drug for patients, accounting to 45% were due to patient non-compliance and drug interaction which was minor. Need for additional drug therapy was the third most identified accounting 13% were due to medical indication indicate the need of drug therapy.Conclusions: The foremost commonly observed DTP is unnecessary therapy and patient non-compliance to the drugs. The study suggests that DTPs are significantly occurring in hospital can cause the patient for comorbidity, prolonged hospitalization. The study suggests that clinical pharmacist and general practitioners can work together to spot and resolve the DTPs.
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