中国临床药师工作模式的系统性评价

目的:评价中国临床药师干预效果的研究,考察临床药师的干预模式,评价临床药师的干预结果。方法:检索PUBMED、COCHRANE、CNKI、万方、维普数据库,纳入中国临床药师干预的随机对照试验,两名评价员按照固定的纳入排除标准,独立对文献资料进行提取。结果:共纳入临床药师参与的随机对照试验25篇,干预领域从高到低依次为内分泌科、呼吸科、心血管科、抗感染科、肿瘤科。干预方式为医院药学信息服务、药物认知或生活方式干预、患者教育与用药咨询、出院用药与随访、建立医疗团队等项目。药师干预的一级、二级、三级、四级有效率分别为50%、75%、76%、86%。结论:临床药师的干预可以提高依从性、认知度,降低患者不良反应发生率的药费。临床药师工作模式已经初见成效,但我国药学服务的模式与评价模式仍有待改善。

Evaluation and systematic review of working mode of clinical pharmacists in China

Objective:To investigate the intervention of clinical pharmacists in China in order to explore pharmaceutical service model and to evaluate the intervention results of clinical pharmacists.Methods:The PubMed, Cochrane, CNKI, WANFANG and VIP database were retrieved for RCTs about pharmacist-care interventions among patients. Two reviewers extracted information from literatures according to inclusion criteria.Results: A total of 25 articles were included in the randomized controlled trials of clinical pharmacists. Rank of studies classiifed according to the therapeutic area includes endocrinology, respiration, cardiovascular, anti-infection and oncology. The pharmacist intervention is providing hospital pharmacy information service, enhancing cognition on medicine offering the life style intervention, offering patient education and medication consultation, giving assistance on hospital discharge medication and follow-up and establishing medical team. The ifrst to fourth levels of study outcome from intervention were 50%, 75%, 76% and 86%.Conclusion:Clinical pharmacist intervention can improve the compliance, awareness and decreased in patients with adverse drug reaction rate and expenditure. Pharmaceutical service and evaluation mode still need to be improved although clinical pharmacists working mode has achieved initial success in China.