| Objectives:Currently,there is no standard for pharmaceutical care,and for patients with complicated treatment regimens,it is difficult to meet their needs with conventional pharmaceutical care.This research aims to exploring the feasibility of improving the treatment outcome,reducing the treatment cost and promoting rational drug use,by establishing multi-disciplinary pharmacist team taking grading pharmaceutical care on patients with complex digestive surgery.The standard mode of pharmaceutical care was explored by establishing of grading pharmaceutical care standard based on specialty,and this pharmaceutical care mode could be applied among clinical pharmacists.Methods:This study was a prospective,open and randomized controlled trial.Patients undergoing complex digestive surgery in a large general hospital were divided into intervention group and control group,a total of 216 patients were enrolled from May 2018 to December 2019,with 108 patients in the control and intervention group respectively.Patients in the intervention group receiving grading pharmaceutical care provided by multi-disciplinary pharmacist team according to the established standards,the pharmaceutical care covering anti-infection,anti-coagulation,nutrition,pain was carried out according to the perioperative treatment needs of the patients.Patients in the control group received conventional treatment.The therapeutic effect and rational drug use indexes were compared between the intervention group and the control group to evaluate the effectiveness of multi-disciplinary pharmacist team in pharmaceutical care and explore the feasibility of grading pharmaceutical care.Results:Treatment effectiveness:1.the effective rate of anti-infection in the intervention group(96.30%)was significantly higher than that in the control group(89.81%),showing a significant difference(P=0.021);2.the incidence of thrombus in the intervention group was significantly lower than that in the control group;3.the pain control rate of the intervention group(95.30%)was higher than that in the control group(72.40%),showing a significant difference(P=0.001);4.Serum albumin and prealbumin levels in the intervention group were significantly higher than those in the control group(P=0.014,0.043).The results showed that the pharmaceutical care played an important role in the treatment.Rational drug use:1.Compared with the control group,the drug expenditure of the intervention group reduced 7533.09 yuan/person(P=0.033).2.The proportion of drugs in the intervention group(25.10%)was significantly lower than that in the control group(32.24%).3.The abnormal cost of monitored drugs in the intervention group(303.43 yuan)was significantly lower than that in the control group(801.28 yuan).4.The intensity of antimicrobial use in the intervention group(83.48)was significantly lower than that in the control group(133.01).The results showed that the unnecessary drug expenditure was saved and the treatment expenditure structure was more reasonable by pharmaceutical care.Conclusion:For complicated digestive surgery patients,grading pharmaceutical grade by multi-disciplinary pharmacist team can significantly improve treatment outcome of anti-infection,anticoagulation,nutrition and pain,save unnecessary drug expenditure,optimize treatment expense structure,ensuring the safety,effectiveness and economy of drug treatment.And exploring the establishment of grading pharmaceutical care,provide reference of pharmaceutical care for clinical pharmacists. |
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