The Role Of Clinical Pharmacists In The Clinical Pathway Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: The aim of the research is to study the role of the clinical pharmacists in the clinical pathway of AECOPD by treatment regimen evaluation,medical order audit,adverse drug reaction monitoring,medication education,treatment effect evaluation,compliance monitoring,and satisfaction evaluation by means of pharmacy rounds.Methods: The patients in the control group and the intervention group were AECOPD patients who were hospitalized in the respiratory department of a grade III A hospital from March 2017 to December 2017 and March 2018 to January 2019 respectively.There were 80 cases in the control group and 85 cases in the intervention group.The control group used retrospective study,without the participation of clinical pharmacists,which doctors made diagnosis according to the patient’s condition after admission(including clinical manifestations,laboratory examinations,imaging examinations,etc.)and then treated accordingly.The intervention group used prospective research method,during which the clinical pharmacists participated in the evaluation of patients’ treatment plans,conducted medical order audit and educated patients on medication to implement individualized service treatment.The intervention group adopted the management mode of PDCA cycle and carried out two cycles.The main indicators were average hospitalization days,total hospitalization costs,total drug costs,antibiotics costs,adverse drug reaction reporting rates,average DDD number of antibiotics,antibiotics combination utilization rate,patient compliance and satisfaction.Result: 1.Comparison between the intervention group and the control group: Compared with the intervention group and control group,the average hospitalization days,the total cost of hospitalization,the total cost of drugs,the cost of antibiotics,the average DDD number of antibiotics in the intervention group were significantly lower than those in the control group(P<0.05).The adverse drug reaction reporting rate in the intervention group was significantly higher than that in the control group(P<0.05).There was no significant difference in the antibiotic combination utilization rate between the two groups(P>0.05).2.Comparison between the two cycles in the intervention group: Total hospitalization expense in the second cycle were significantly lower than that in the first cycle,and the rate of medication compliance was significantly higher than that in the first cycle(P<0.05).There were no statistically significant differences in hospitalization days,total drug costs,and adverse drug reaction reporting rate in the two cycles of the intervention group(P>0.05).Conclusion: The participation of clinical pharmacists in the implementation of clinical pathway for patients with AECOPD can significantly improve medication compliance,rational use of antibiotics and adverse drug reaction reporting rate,reduce hospitalization days,hospitalization costs and antibiotic utilization rate,and perfect the clinical pharmacists’ participation in clinical pathway of AECOPD.