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肿瘤内科发热性中性粒细胞减少患者药物治疗临床路径的应用探索▲
Application exploration of clinical pathway for drug treatment for patients with febrile neutropenia in the Department of Oncology

内科 202419卷01期 页码:12-17

作者机构:1 广西医科大学附属肿瘤医院药学部,南宁市 530021;2 广西医科大学第一附属医院药学部,南宁市 530021

基金信息:▲基金项目:广西壮族自治疗区卫生健康委员会自筹经费科研课题(Z20210980)

DOI:10.16121/j.cnki.cn45-1347/r.2024.01.03

  • 中文简介
  • 英文简介
  • 参考文献

目的 在肿瘤内科建立发热性中性粒细胞减少(FN)患者药物治疗临床路径(临床药径),以促进临床合理用药,降低药品费用支出。方法 基于93例肿瘤内科FN患者的用药合理性分析,建立以循证药学为基础的FN临床药径,并采用计划‑实施‑检查‑处理循环法对其进行完善。比较FN临床药径实施前后FN患者抗菌药物应用情况、抗菌药物联合应用情况、血培养送检率和 “升白”药物不合理应用情况。结果 FN临床路径实施后,抗菌药物总不合理占比、疗程过长占比、疗程和人均用药金额均低/短于实施前;抗菌药物单用占比和血培养送检率均较实施前明显上升,抗菌药物二联占比较实施前降低;应用“升白”药物总不合理率较实施前低(均P<0.05)。结论 在肿瘤内科建立基于循证药学的FN患者临床药径新模式,可促进临床合理用药,减少药品费用支出,降低患者经济压力。

Objective To establish a clinical pathway for drug treatment (clinical drug pathway) for patients with febrile neutropenia (FN) in the Department of Oncology, which aims to promote the rational medication in clinical practice and reduce drug costs. Methods Based on the analysis of the medication rationality of 93 patients with FN in the Department of Oncology, a clinical drug pathway for FN was established on the basis of evidence-based pharmacy and improved using the Plan-Do-Check-Act cycle method. The application of antimicrobial drugs, the combined application of antimicrobial drugs, the blood culture rate, and the irrational application of leukocyte boosters in patients with FN before and after the implementation of the clinical drug pathway for FN were compared. Results After the implementation of the clinical drug pathway for FN, the proportions of patients with irrational application of antimicrobial drugs and excessively long antimicrobial course, antimicrobial course, and per capita drug cost were lower/shorter than those before the implementation; the proportion of patients only using one antimicrobial drug and the blood culture rate were significantly higher than those before the implementation, and the proportion of patients using two antimicrobial drugs decreased compared with that before the implementation; the rate of irrational applications of leukocyte boosters was lower than that before the implementation (all P<0.05). Conclusion The new clinical drug pathway for patients with FN established on the basis of evidence-based pharmacy in the Department of Oncology can promote the rational medication in clinical practice, reduce drug costs, and relieve the economic pressure for patients.


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