医务人员教育活动对治疗药物监测有效应用的影响。

Takanori Miura, R. Kojima, Youji Sugiura, M. Mizutani, F. Takatsu, Yoshio Suzuki
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引用次数: 1

摘要

最近有报道称,治疗性药物监测(TDM)在药物剂量方案的最佳个体化中起着重要作用。然而,众所周知,TDM存在一些陷阱,包括不适当的血液采样,这些陷阱被认为可能是由于医务人员,特别是医生和护士缺乏TDM教育。因此,在本研究中,我们试图确定医务人员对TDM知识的提高是否会导致更好的药物治疗(例如剂量设计)。因此,向医务人员讲授了TDM药剂师的几点知识,包括血液取样。经TDM教育后,执行时间与滴药、采血记录时间时间差的发生率明显降低。TDM教育前门诊患者采血不足发生率为90%,TDM教育后仅为14.5%。TDM教育在给药方案、药物评价、副作用监测、药物相互作用和依从性等方面均有改善,药物治疗的有效性明显高于TDM教育前。这些结果表明,药师对医务人员进行TDM教育,可以显著提高药物治疗的临床效果,并有助于避免错误给药。
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Effect of Educational Activity to the Medical Staffs on a Useful Application of Therapeutic Drug Monitoring.
It has recently been reported that therapeutic drug monitoring (TDM) plays an important role in the optimal individualization of drug dosage regimens. However, TDM is known to have some pitfalls including inappropriate blood sampling, and these pitfalls are considered to possibly result from a lack of TDM education by the medical staffs, especially doctors and nurses. In the present study, we thus tried to determine whether an improved knowledge about TDM by the medical staff would result in a better drug therapy (e.g. dosage design). The medical staff was thus taugth about TDM pharmacists regarding several points, including a blood sampling. After this TDM education, the incidence of a time difference between the enforcement time and the recording time of drug dripping and blood sampling significantly decreased. The incidence of inadequate blood sampling in outpatients was 90% before TDM education, while after such education, it was only 14.5%. TDM education improvements were observed in the dosage regimens, drug evaluation, and monitoring of side effect, drug interaction and compliance, and thus, effectiveness of drug therapy was a much higher, than that before TDM education. These results suggest that an improved educational program for TDM given by pharmacists for medical personnel may thus significantly improve the clinical effectiveness of drug therapy and also help to avoid errors drug administration.
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