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房颤患者抗凝治疗信息化药学监护路径的探索与实践
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| 篇名： | 房颤患者抗凝治疗信息化药学监护路径的探索与实践 |
| TITLE： | Exploration and practice of information-based pharmaceutical care pathway of anticoagulant therapy in patients with atrial fibrillation |
| 摘要： | 目的 建立房颤患者抗凝治疗信息化药学监护路径，提高房颤患者治疗有效性和安全性。方法借助我院医疗及智能决策支持系统开发“抗凝药学监护”模块，对房颤患者进行血栓栓塞及出血风险评估，对抗栓药医嘱开展前置审核，实施疗效监护、药物相互作用监控及不良反应（ADR）预警，完成患者的全程化管理。结果共纳入接受抗凝治疗的1228例患者，分析其医嘱后发现9.27％纠正了错误的抗凝方案，3.99％调整了潜在不良相互作用或ADR风险医嘱，医嘱干预成功率为70.29％。实行信息化药学监护后，抗凝治疗率由88.73％提高至97.40％，华法林治疗患者的凝血国际标准化比值院内达标率由38.64％提高至66.67％，严重出血事件发生率由2.94％降至0.37％（P＜0.05）。结论房颤患者抗凝治疗信息化药学监护路径可实现对患者全面、高效、精准的管理，提高抗凝治疗的合理率、有效性及安全性。 |
| ABSTRACT： | OBJECTIV E To develop the infor mation-based pharmaceutical care pathway of anticoagulant therapy in patients with atrial fibrillation and improve the efficacy and safety of treatment for them. METHODS The“anticoagulant pharmaceutical care”module was developed on the basis of medical intelligent and decision system. Patients with atrial fibrillation were taken pharmaceutical care in the whole anticoagulant treatment by evaluating the thromboembolism and bleeding risks ，pre-reviewing antithrombotic prescriptions ，monitoring efficacy and drug interactions ，and warning adverse reactions. RESULTS A total of 1 228 patients receiving anticoagulant therapy were enrolled. It was found after analysis of their doctor ’s orders that 9.27％ of the patients adjusted the improper antithrombotic therapies ，3.99％ modulated treatments according to the effects of potential drug interactions or the risk of adverse reactions ，and 70.29％ of the wrong prescriptions were intervened successfully. After the information-based pharmaceutical care ，the anticoagulation treatment rate increased from 88.73％ to 97.40％，the rate of patients ’achievements to warfarin’s international normalized ratio in hospital increased from 38.64％ to 66.67％，and the incidence of serious bleeding events decreased from 2.94％ to 0.37％ （P＜0.05）. CONCLUSIONS The information-based pharmaceutical care path of anticoagulant therapy achieved comprehensive ，efficient and accurate management of patients with atrial fibrillation ，and improved the rationality ，effectiveness and safety of anticoagulant therapy. |
| 期刊： | 2022年第33卷第17期 |
| 作者： | 李静，周晓，宋惠珠，马红燕，宫颖，钱正月 |
| AUTHORS： | LI Jing，ZHOU Xiao，SONG Huizhu ，MA Hongyan ，GONG Ying，QIAN Zhengyue |
| 关键字： | 房颤；抗凝治疗；信息化；药学监护路径 |
| KEYWORDS： | atrial fibrillation ；anticoagulant therapy ；informatization；pharmaceutical care pathway |
| 阅读数： | 153 次 |
| 本月下载数： | 7 次 |
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