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1.重庆医科大学附属第三医院药剂科,重庆 401120
2.重庆医科大学药学院,重庆 400016
副主任药师,博士。研究方向:临床药学、临床评价。电话:023-60353049。E-mail:duqian@hospital.cqmu.edu.cn
主任药师,博士生导师,硕士。研究方向:天然活性产物、医院药学。电话:023-68766377。E-mail:liusq@hospital.cqmu.edu.cn
收稿日期:2022-04-18,
修回日期:2022-10-10,
纸质出版日期:2022-11-15
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杜倩,奚鑫,董杰,等.药学巡诊:一种新型医院药学服务模式[J].中国药房,2022,33(21):2666-2670.
DU Qian,XI Xin,DONG Jie,et al.Pharmacy active consultation:an innovative model of hospital pharmaceutical services[J].ZHONGGUO YAOFANG,2022,33(21):2666-2670.
杜倩,奚鑫,董杰,等.药学巡诊:一种新型医院药学服务模式[J].中国药房,2022,33(21):2666-2670. DOI: 10.6039/j.issn.1001-0408.2022.21.19.
DU Qian,XI Xin,DONG Jie,et al.Pharmacy active consultation:an innovative model of hospital pharmaceutical services[J].ZHONGGUO YAOFANG,2022,33(21):2666-2670. DOI: 10.6039/j.issn.1001-0408.2022.21.19.
药学巡诊是指临床药师主动前往临床科室,协助医师解决临床中用药相关问题,提出药物治疗意见或提供药学服务的活动,并形成有医疗效力的文书记录。药学巡诊与药学会诊的区别,在于后者一般是由临床医师提出,在医院信息系统中向药剂科发出会诊邀请,临床药师接收后前往会诊,而前者是由临床药师主动到临床科室开展的药学服务模式。在常规药学巡诊的基础上,我院临床药师还进一步开展了专项巡诊(包括对多重耐药菌阳性患者的即时专项巡诊、对药物性肝损伤患者的主动监测与干预)以及以药学巡诊回访形式开展的药学监护等。药学巡诊及其专项巡诊具有主动、及时、广覆盖的特点,可以作为传统驻科形式的补充,帮助药学部门提升服务效能,为医疗机构开展高效药学服务提供新角度,也为国家药事服务改革提供新思路。
Pharmacy active consultation refers to the spontaneous activity that clinical pharmacists take the initiative to go to clinical departments to help doctors solve problems related to drug use in clinical practice,put forward drug treatment suggestions or provide pharmaceutical services,and form medical documents. The difference between pharmacy active consultation and pharmacy consultation is that the latter is generally proposed by the clinician,who sends a consultation invitation to the pharmacy department in the hospital information system,and the clinical pharmacist will go to the consultation after receiving it,while the former is a pharmaceutical service mode that the clinical pharmacist takes the initiative to carry out in the clinical department. On the basis of routine pharmacy active consultation,clinical pharmacists in our hospital also further carried out a special active consultation mode (including prompt special active consultation for patients with multidrug resistance bacteria positive,active monitoring and intervention for patients with drug-induced liver injury),and patient pharmaceutical supervision in the form of return visit of pharmacy active consultation. Pharmacy active consultation and its special active consultation possess the characteristics of initiative,early and extensive coverage,as a supplement to resident clinical pharmacy services. Pharmacy active consultation could help the pharmacy department to improve service efficiency,provide a new perspective for medical institutions to carry out efficient pharmaceutical services,and supply new ideas for the reform of pharmaceutical services in China.
崔力 , 席晓宇 , 姚东宁 , 等 . 我国三级医院临床药学服务现状及问题研究:(三)临床药学服务开展现状分析 [J ] . 中国药学杂志 , 2018 , 53 ( 10 ): 837 - 842 .
席晓宇 , 姚东宁 , 黄元楷 , 等 . 我国三级医院临床药学服务现状及问题研究:(四)相关主体对临床药学服务态度分析 [J ] . 中国药学杂志 , 2018 , 53 ( 13 ): 1123 - 1129 .
邱欣 , 王艳 , 隋永 , 等 . 鲁南地区基层医疗机构在“新医改”背景下开展药学服务的调查分析 [J ] . 中国当代医药 , 2016 , 23 ( 25 ): 159 - 161 .
邓庆华 , 邓建华 , 杨建英 , 等 . “新医改”背景下基层医疗卫生机构开展药学服务现状的调查分析 [J ] . 中国药房 , 2014 , 25 ( 40 ): 3748 - 3751 .
刘东 , 张程亮 , 桂玲 , 等 . 湖北省二级以上医院临床药学服务开展现状调查 [J ] . 药物流行病学杂志 , 2011 , 20 ( 4 ): 186 - 188 .
邢园 , 李歆 . 三级综合医院临床药学服务实施现状调查与分析 [J ] . 南京医科大学学报(社会科学版) , 2016 , 16 ( 1 ): 10 - 14 .
福建省医疗保障局 . 福建省医疗保障局关于在省属公立医院试行药学服务收费政策的通知 [EB/OL ] .( 2022-04-14 )[ 2022-04-16 ] . http://ybj.fujian.gov.cn/zfxxgkzl/fdzdgknr/zcwj/202204/t20220414_5891649.htm http://ybj.fujian.gov.cn/zfxxgkzl/fdzdgknr/zcwj/202204/t20220414_5891649.htm .
于乐成 , 茅益民 , 陈成伟 . 药物性肝损伤诊治指南 [J ] . 临床肝胆病杂志 , 2015 , 31 ( 11 ): 810 - 820 .
AITHAL G P , WATKINS P B , ANDRADE R J , et al . Case definition and phenotype standardization in drug-induced liver injury [J ] . Clin Pharmacol Ther , 2011 , 89 ( 6 ): 806 - 815 .
Council for International Organizations of Medical Sciences (CIOMS) . Drug-induced liver injury (DILI):Current status and future directions for drug development and the post-market setting [EB/OL ] . ( 2020-08-21 )[ 2022-02-01 ] . https://cioms.ch/wp-content/uploads/2020/06/CIOMS_ DILI_Web_16Jun2020.pdf https://cioms.ch/wp-content/uploads/2020/06/CIOMS_DILI_Web_16Jun2020.pdf .
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