PCNE分类系统对2型糖尿病合并慢性肾脏病患者的合理用药评价研究

目的 运用欧洲医药保健网(pharmaceutical care network of Europe，PCNE)分类系统了解2型糖尿病(type 2 diabetes mellitus，T2DM)合并慢性肾脏病(chronic kidney disease，CKD)患者的合理用药情况。方法 调取2021年1月—4月在保定市第一中心医院内分泌科住院的T2DM合并CKD患者的出院病历120份，采用横断面研究设计，对病例中的医嘱进行回顾性审核，依据PCNE分类系统对发现的药物相关问题(drug-related problems，DRPs)进行分类汇总。结果 本研究纳入的120例患者中共发现101个DRPs，其中治疗有效性、治疗安全性和其他问题分别有51，38，12个。引起DRPs前3位的原因依次是药物选择、剂量选择、药物使用过程。结论 在T2DM合并CKD患者药物治疗过程中，内分泌临床药师可针对性加强干预手段，如加强根据肾功能情况进行药物的选择、用药剂量与频次的调整、药物相互作用的分析等，从而预防类似DRPs的再次发生，保证患者用药安全。

Study on Rational Drug Use Evaluation in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease by PCNE Classification System

OBJECTIVE To find out the situation of rational use of drugs for type 2 diabetes mellitus(T2DM) patients with chronic kidney disease(CKD) by using the classification system of pharmaceutical care network of Europe(PCNE). METHODS The 120 discharged medical records for T2DM patients with CKD who were hospitalized in the department of endocrinology in Baoding No.1 Central Hospital from January to April 2021 were retrieved. The medical orders in the cases were reviewed retrospectively by cross-sectional study design, and the drug-related problems(DRPs) were classified and summarized according to PCNE classification system. RESULTS A total of 101 DRPs were found in 120 patients, including 51, 38 and 12 problems with treatment safety, treatment effect and other aspects respectively. The top three causes of DRPs were drug selection, dose selection and drug use process. CONCLUSION In the course of drug treatment for T2DM patients with CKD, clinical pharmacists in endocrine department can strengthen intervention measures, such as strengthening the selection of drugs based on renal function, the adjustment of dosage and frequency, and the analysis of drug interaction, so as to prevent the recurrence of similar DRPs and ensure the safety of medication for patients.