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儿童罕见病多学科诊疗的药学服务模式探索
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| 篇名： | 儿童罕见病多学科诊疗的药学服务模式探索 |
| TITLE： | Exploration of pharmaceutical service model in multidisciplinary diagnosis and treatment of rare diseases in children |
| 摘要： | 目的 探索儿童罕见病多学科诊疗（MDT）的药学服务模式。方法四川大学华西第二医院（以下简称“我院”）临床药师参与儿童罕见病MDT过程，通过基于循证实践制定药物治疗方案，提高治疗药物可及性，药学监护，药物治疗管理，全程参与患儿诊疗过程，构建儿童罕见病MDT的药学服务模式。结果2021年1月－2022年4月，我院临床药师共累计参与39例罕见病患儿的MDT，包括罕见病住院患儿21例，罕见病门诊患儿18例，共涉及23种罕见病；完成罕见病住院患儿药学查房45例次、药学会诊26例次，罕见病门诊患儿MDT讨论25例次、药学门诊5例次，院内外罕见病患儿用药教育38例次，院外患儿随访25例次。有24例（61.54%）患儿涉及超说明书用药，涉及13种罕见病和16种治疗药品，其中11种药品已完成或正在进行超说明书用药备案；3种药品完成临时采购药品审核评估；完成医保药品和高值药品处方审核268例次。结论我院初步建立了儿童罕见病MDT“院内+院外、线上+线下”的闭环药学服务模式，该模式提高了我院儿童罕见病治疗药物的院内可及性、临床应用的规范性及儿童罕见病的诊疗水平。 |
| ABSTRACT： | OBJECTIVE To explore the pharmaceutical service model in multidisciplinary diagnosis and treatment （MDT） of rare diseases in children. METHODS Clinical pharmacists of West China Second University Hospital （hereinafter referred to as “our hospital”） participated in the process of MDT of children’s rare diseases. Clinical pharmacists took part in the entire diagnosis and treatment process of children and established the MDT pharmaceutical service model of children’s rare diseases by formulating drug treatment plans based on evidence-based practice， improving the accessibility of drugs， pharmaceutical monitoring and drug treatment management. RESULTS From January 2021 to April 2022， clinical pharmacists of our hospital had participated in a total of 39 cases of rare diseases MDT in children， including 21 hospitalized children with rare diseases and 18 outpatient com children with rare diseases， involving a total of 23 rare diseases. Clinical pharmacists completed 45 pharmaceutical zhanglingli@scu.edu.cn rounds and 26 pharmaceutical consultations for rare diseases inpatients， 25 outpatients’ MDT and 5 pharmaceutical outpatient service for outpatients with rare diseases， 38 medication educations for inpatients and outpatients with rare diseases and 25 follow-up services for out-of-hospital patients. There were 24 cases （61.54%） of off-label drug use， involving 13 rare diseases and 16 therapeutic drugs， among which off-label drug use registration of 11 drugs had been completed or was in progress. The temporary purchase evaluations of 3 drugs had been completed； 268 cases of medical insurance drug and high-value drug prescription had been reviewed. CONCLUSIONS Our hospital have primarily established a loop pharmaceutical service model of MDT for children with rare diseases， which covers inpatients and outpatients. The model improves the availability and standardization of clinical application of therapeutic drugs， and diagnosis and treatment level for children with rare diseases in our hospital. |
| 期刊： | 2023年第34卷第08期 |
| 作者： | 黄亮；王其琼；陈力；俞丹；吴瑾；林芸竹；曾力楠；贾知军；成果；张伶俐 |
| AUTHORS： | HUANG Liang，WANG Qiqiong， CHEN Li，YU Dan，WU Jin，LIN Yunzhu，ZENG Linan，JIA Zhijun，CHENG Guo，ZHANG Lingli |
| 关键字： | 儿童；罕见病；多学科诊疗；临床药师；药学服务 |
| KEYWORDS： | children； rare diseases； multidisciplinary team diagnosis and treatment； clinical pharmacists； pharmaceutical service |
| 阅读数： | 714 次 |
| 本月下载数： | 11 次 |
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