我院开展治疗药物监测的体会

目的:为促进临床药学服务开展提供参考。方法:对我院2004年至今治疗药物监测(TDM)过程中所发现的问题从患者、医师、护理人员3方面进行归纳、总结,并提出建议。结果与结论:TDM中患者存在自行更改剂量、未规律服药等问题,建议药师加强与患者沟通、主动收集药物监测信息、针对患者进行用药教育等;医师存在血药浓度影响因素考虑不全、药学化学知识不足等问题,建议加强药师与医师沟通,共同为患者制订给药方案等;护理人员存在抽血部位选择不当、标本储存不当等问题,建议对护理人员讲解相关TDM知识或利用医院信息平台发布监测知识等。药师可通过TDM平台促进药学服务的开展。

Experience of Developing Therapeutic Drug Monitoring in Our Hospital

OBJECTIVE： To provide reference for the development of pharmaceutical care in the clinic. METHODS： Problems occurring in the period of therapeutic drug monitoring since 2004 were summarized in respect of patient, physician and nurse and some suggestions were put forward. RESULTS ＆ CONCLUSIONS： There were many problems during the period of therapeutic drug monitoring. For patients, changing drug dosage by oneself and irregular administration required that pharmacists should strength the communication with patients, collect drug monitoring information ＂and develop medication education, etc. For physi- cians, thoughtless consideration on the influence factor of plasma concentration, deficient chemical and pharmaceutical knowledge required to enhance the communication between pharmacists and physicians and to design drug regimen together, etc. For nurse, in- correct selection of phlebotomizing site and incorrect storage of samples required to interpret relative knowledge of therapeutic drug monitoring and to publish monitoring items by hospital information platform, etc. Pharmacists can promote the development of pharmaceutical care by therapeutic drug monitoring platform.