妊娠期哺乳期药物咨询门诊的开设与实践

目的交流妊娠期和哺乳期药物咨询门诊的工作模式、基本要素和累积数据。方法以微信形式初步调研了浙江省妊娠期和哺乳期用药相关的药学门诊的开设概况,并就我院2016年1月至2019年8月药学门诊的咨询要素、就诊人次、构成、咨询排名前10位的药品和疾病种类以及常见的非药物因素,进行阶段性的回顾分析和讨论。结果妊娠期哺乳期用药门诊的专科特色决定了非药物性相关信息收集的重要性;门诊咨询问题以妊娠期用药为主,其中意外妊娠后的药物咨询人次远多于备孕咨询;咨询药品占比较高的为抗菌药物、紧急避孕药和抗感冒药物;非药物因素以饮酒、X线、CT检查相关的咨询为主;排除咨询者自行用药外,主要用药原因为妊娠合并甲状腺疾病、乙型肝炎和多囊卵巢综合征。结论在妊娠期和哺乳期药物咨询门诊中,需要关注咨询者用药之外的信息,并给予个体化建议,而科普宣教远重于事后的药学服务。

Establishment and practice of drug consultation clinic for pregnant and lactating women

Objective To exchange the working mode,basic elements and accumulated data of medication consultation clinic for pregnant and lactating women.Methods A preliminary survey of the establishment of pharmaceutical clinics related to pregnancy and lactation in Zhejiang Province was made using WeChat,and the consultation elements,number of visits,composition,top ten drugs and disease types and some common non-drug factors of pharmaceutical clinics in our hospital from January 2016 to August 2019 were analyzed and discussed.Results The special features of the medication clinic for pregnant and lactating women determined the importance of collection of all the relevant information besides drugs.Drug use during pregnancy was still the main problem of outpatient consultation,and the number of drug consultation after unexpected pregnancy was much more than that during pregnancy preparation stages.Antibacterial drugs,emergency contraceptives and anti-cold drugs accounted for a relatively high proportion of consultation drugs;non-drug factors were mainly alcohol consumption,X-ray and CT examination.The main causes of medication were thyroid diseases,hepatitis B and polycystic ovary syndrome after self-medication of consultants being excluded.Conclusion Medication consultation from women during pregnancy and lactation makes it necessary for pharmacists to pay close attention to extra-drug information and give individualized suggestions,and it is worth mentioning that popular science education is far more important than later pharmaceutical care.