The Effect Of Clinical Pharmacists In The Consultation Of Infectious Diseases In Elderly Patients

ObjectiveBecause of the decline of physiological function and the atrophy of tissues and organs,the elderly are more likely to suffer from infectious diseases,especially serious bacterial infections.Therefore,it is particularly important to understand the characteristics of common infections and medication in the elderly in advance for later empiric medication and formulation of relevant medication schemes.By analyzing the data of antibacterial drug consultation participated by clinical pharmacists in our hospital,this present study summarized the characteristics of infectious diseases in elderly patients,evaluated the effect of anti-infection consultation intervention participated by clinical pharmacists,and discussed its advantages and disadvantages,so as to provide reference for empirical drug use and future clinical diagnosis and treatment.In addition,one of the representative cases was selected to implement individualized pharmaceutical care in order to explore the key points of clinical pharmacist consultation and provide evidence-based medical evidence for further improving the quality of consultation.Methods1.In this paper,retrospective analysis was used to collect the cases of clinical pharmacists participating in the consultation of elderly patients with infectious diseases aged over 60 years from 2014 to 2016.The basic information,infection sites,pathogens and medication of the elderly patients were summarized and analyzed,and the consultation mode,consultation purpose,consultation distribution departments,the adoption of consultation opinions and the clinical prognosis were statistically analyzed.2.Using the platform of Weixin Joint Questionnaire Star,we conducted online questionnaires for clinicians in our hospital,and summarized and analyzed the results of the questionnaires.3.We selected a typical case in consultation,reviewed relevant medical history and medical history,and made pharmaceutical care and medication analysis.Result1.Characteristics of infectious diseases and use of antibiotics in elderly inpatients.Among the 355 cases of consultation included in this study,254 cases(71.55%)had basic diseases,and the most common basic diseases were hypertension and diabetes.61.13 % of abnormal liver and 66.48 % of abnormal kidney.The infection site was widely distributed,most of which was pulmonary infection.Most of the pathogenic bacteria were gram negative,accounting for 55.08 %.The most frequently used antibiotic was levofloxacin,accounting for 28.17 %.2.Effectiveness evaluation of clinical pharmacists' anti-infection consultation.Clinical pharmacists in our hospital participate in the consultation of infectious diseases in the elderly,which covers 41 departments.The main purpose of consultation is to select and adjust antibacterials.The rate of acceptance of consultation opinions is as high as 87.60%,and the prognosis is improved significantly compared with the non-acceptance group(P < 0.05).The results of the questionnaire showed that 95.48% of the clinicians knew about the occupation of clinical pharmacists,and 40.11% of them knew about clinical pharmacists through consultation.The knowledge content that clinicians most expect clinical pharmacists to provide is the adjustment of drug action for special population,accounting for 64.97%.The clinicians thought that the consultation opinion of clinical pharmacists was more helpful to their treatment plan,accounting for 86.44%.3.Pharmaceutical care practice: case analysis of elderly patients with pulmonary infection complicated with diabetes.By combining the characteristics of infectious diseases in elderly patients,clinical pharmacists analyzed the patient's condition and medication status,considered the high-risk pathogenic bacteria of elderly patients with infectious diseases with pseudomonas aeruginosa as the partner of diabetes,and assisted clinicians in adjusting the medication plan.The patient was discharged from the hospital after 19 days.ConclusionInfectious diseases in elderly patients are complex.Clinical pharmacists can provide targeted pharmaceutical care according to their characteristics and significantly improve their prognosis.The consultation work of clinical pharmacists is generally recognized by clinicians,but the clinical experience,the participation rate of clinical treatment and the popularity rate of clinical pharmacists need to be strengthened.