Practice and Research of Management Mode of Long-term Medication Safety Assessment for the Patients with Chronic Obstructive Pulmonary Disease by Pharmacist Team in Medical Treatment Alliance / 中国药师

Objective:To explore the new management mode of long-term medication safety assessment for chronic obstructive pul-monary disease (COPD) with the participation of pharmacist team in medical treatment alliance to provide reference for pharmacists participating in the management of chronic diseases under the new situation of new medical reform. Methods:Totally 126 patients with COPD meeting the inclusion criteria in our hospital and medical treatment alliance were selected. The patients received medication management including drug safety comprehensive evaluation,classification management,follow-up with medication guidance,integrat-ed prescriptions checking and shared database building etc with the participation of our clinical pharmacists to guide the community pharmacists in coordination with physicians. Results:After one-year management mode practice,the cognitive ability of safe medica-tion and compliance of the patients significantly increased(P<0.01) with significant improvement of control situation of COPD(CAT score) (P<0.05 or P<0.01), and the capacity of effective identification and irrational prescription intervention significantly in-creased (P<0.01). Conclusion:The management mode of long-term medication safety assessment for COPD patients with the partic-ipation of pharmacist team in medical treatment alliance has significant effects on COPD patients' safe medication and drug efficacy, which can improve the professional service of pharmacist team.

Practice of Management Mode of Long-term Medication Safety Assessment for Chronic Airway Disease Patients Established by Pharmacists Team of Medical Consortium / 中国药房

OBJECTIVE:To provide reference for pharmacists to participate in the management of chronic disease. METHODS:A total of 259 patients with chronic airway disease [included asthma and chronic obstructive pulmonary disease (COPD)] met the inclusion criteria were selected from our hospital and 5 community health care centers of medical consortium. These patients received medication safety assessment management,which was led by clinical pharmacists of our hospital with the participation of community pharmacists,including medication safety comprehensive evaluation and risk classification management, follow-up and medication guidance, integrated prescriptions checking, establishment of shared database. 1 years after the implementation,the effectiveness were evaluated by score the relatived indicators in related groups. RESULTS:After a year of the management mode practice,compared with before intervention,the patients'safety medication cognitive ability score in high-risk and low-risk group increased from(4.49±1.26)and(7.31±1.01)to(5.40±1.56)and(7.44±0.91);medication adherence score increased from(4.96±1.21)and(7.08±1.24)to(6.66±1.08)and(7.38±0.98);ACT score from asthma patients increased from (16.15±2.58)and(21.15±1.03)to(16.80±2.57)and(21.64±1.55);CAT score from COPD patients decreased from(25.51± 4.07) and (14.90 ± 3.95) to (24.20 ± 3.96) and (13.80 ± 4.08);the rate of irrational prescription effective identification and intervention by pharmacists increased from 3.6％ and 1.4％ to 9.4％ and 7.6％,respectively. All the differences above were statistically significant (P<0.05). CONCLUSIONS:The participation of pharmacists in long-term medication safety assessment management for chronic airway disease patients can improve patients'safety medication cognitive ability,medication adherence, disease control and the pharmacists'ability of irrational drug use identification and intervention.

Clinical Utilization Investigation and Rationality Analysis of Carbapenems in A Hospital / 中国药房

OBJECTIVE:To explore the clinical utilization of carbapenems in a hospital,analyze and evaluate its medication rationality. METHODS:All the 508 medical records of inpatients treated with carbapenems from Jul. 2012 to Jun. 2015 were retro-spectively investigated,the utilization and pathogenic examination of carbapenems were evaluated;by setting the carbapenems eval-uating standard,the medication rationality of carbapenems was evaluated and inappropriate cases were classified and analyzed statis-tically. RESULTS:The drug utilization indexed (DUI) of Imipenem and cilastatin sodium for injection and Meropenem for injec-tion were 0.80 and 1.32,respectively;the total rate of microbial inspection was 95.9%;according to the drug sensitive test result, the rate of drug selection was 62.8%;there were 54 cases(10.6%)of irrational use records,in which,irrational dosage(42.6%) and improper drug selection (31.4%) were the major problems. CONCLUSIONS:There are some inappropriate medication prob-lems in carbapenems utilization in the hospital. Developing the carbapenems utilization evaluation is helpful to discover typical medi-cation problems,which can provide reference for intervention and continuous improvement of rational drug use.

Analysis behavior of patients with serious adverse drug reaction using statins leading to rhabdomyolysis / 中国基层医药

Objective To analyze the behavior of patients with serious adverse drug reactions and look for risk factors leading to serious adverse drug reactions .Methods Patient medication behavior evaluation method was established,which was used in cases of serious adverse reaction caused by stains in recent three years in Beijing Chuiyangliu Hospital .Clinical pharmacists participated in field survey .Medication behavior of patients was analyzed from three aspects of knowledge ,attitude and ability .Results Three patients had serious adverse reactions occurred in recent 3 years,drugs were suspected of simvastatin and atorvastatin .The score of medication knowledge was lower than 20%.The score of health attitude was lower than 20%.The score of taking ability was lower than 20%. Conclusion In the investigation of serious adverse reaction ,pharmacists found the risk behavior of patients with daily medication is an important cause of patients with serious adverse reaction .Pharmacists should strengthen the drug education and publicity ,especially in patients with risk factors of medication behavior such as knowledge ,attitude and ability in their daily work .

Participation of Clinical Pharmacists in Pulmonary Infection Therapy for a Patient with Hypersensitivity to Several Kinds of Antibiotics / 中国药房

OBJECTIVE:To investigate the role of clinical pharmacist in pulmonary infection therapy for a patient with hyper-sensitivity to several kinds of antibiotics. METHODS:Through admission evaluation,clinical pharmacists participated in the formu-lation of pulmonary infection therapy regimen for a patient with hypersensitivity to several kinds of antibiotics. According to clinical efficacy and disease condition,clinical pharmacists adjusted therapy plan and provided individual pharmaceutical care. RESULTS:Physician adopted clinical pharmacist’s suggestions,and then the patient transferred to community hospital after pulmonary infec-tion had been controlled. CONCLUSIONS:Clinical pharmacists adopt admission assessment and classification management,posi-tion high risk patient,provide whole-course pharmaceutical care,and help physician to optimize and promote therapy plan,in or-der to guarantee the safety of drug use.

HPLC fingerprint analysis of Jiketing Granules / 中成药

AIM: To establish the fingerprint analysis method of Jiketing Granules(Fructus Forsythiae,Radix Scutellariae,Radix Bupleuri,etc) by HPLC-UV.METHODS: Aanalysis was performed on an alltima C_(18)(4.6 mm?250 mm,5 ?m) column with a acetonitrile-0.1% acetic acid gradient.Detection time was 55 min.The flow rate was 1.0 mL/min.The montoring wavelength was changed.The colunm temperature was at 30℃. RESULTS: 21 peaks were separated on HPLC fingerprint in Jiketing Granules. CONCLUSION: The method is reliable,accurate and can be used as a quality control for Jiketing Granules.