The Study Of The Role Of Pharmacists In Implementation Of Critical Pathways Of Chronic Obstructive Pulmonary Disease

Objective:Clinical pharmacists by participating in thoroughly clinical pharmacists work of critical pathways in patients with chronic obstructive pulmonary disease, For example, the formulation of treatment and reviewing doctor’s advice, pharmaceutical ward round, pharmaceutical care, medical education, adverse reactions monitoring,supervise inspection of compliance, etc, to study the role of pharmacists in implementation of critical pathways of chronic obstructive pulmonary disease and working mode.Methods:By the method of prospective study, the respiratory patients109cases of A tertiary hospital in shandong province in July2013to June2014in chronic obstructive pulmonary disease with acute aggravating period of is divided into the treatment group and control group.1. Clinical pharmacists participate in critical pathways implementation of the treatment group with chronic obstructive pulmonary disease; however, the control group use model with no help of clinical pharmacists. The formulation of treatment, reviewing doctor’s advice, clinical pharmacist’s pharmaceutical ward round, the doctor’s advice to examine, pharmaceutical care, medical education, adverse drug reactions monitoring and compliance supervisor check as the whole course of the clinical pharmacists work through the implementation of critical pathways of the chronic obstructive pulmonary disease. Through comparative analysis between the treatment group and the control group, average lengths of stay, treatment cost, drug treatment cost, the incidence of adverse drug reactions, evaluation of compliance and satisfaction survey as observation index, studies the role of clinical pharmacist participating in critical pathways implementation.2. By using PDCA cycle management way to manage clinical pharmacists work path, after two cycles of continuous improvement, two cases of such confinement period and hospitalization, medical treatment, the incidence of adverse drug reactions, medication compliance and satisfaction were comparatively analyzed.3. The "Chronic obstructive pulmonary disease clinical pharmacists path table","critical pathways in patients with mission list"," critical pathways in patients with compliance evaluation","critical pathways in patients with satisfaction questionnaire was designed. Clinical pharmacists work in accordance with requirement table form. Clinical pharmacist’s path of chronic obstructive pulmonary disease was formed. The path of clinical pharmacists was continuously improved. The Critical pathways of implementation work mode of clinical pharmacists to participate in chronic obstructive pulmonary disease were studied.Results:1.The statistical results of the treatment group and control group.141cases were included in clinical path management,32cases of variant exit path;109cases were completed the clinical path management.58cases were treatment group and control group was51cases. The treatment group and control group no difference between the average lengths of stay, average hospitalization expenses of such confinement; the average Drug treatment cost reduce353.39yuan. The difference was statistically significant. The incidence of adverse drug reactions:treatment group is7cases and control group has1case; Medication adherence evaluation:a good rate of treatment group was77.59%and58.82%in control group. Satisfaction survey:good control group is94.83%,82.35%in control group. The incidence of adverse drug reactions, medication compliance evaluation, and satisfaction survey difference had statistical significance.2.The statistical results of2PDCA cycles treatment group.The PDCA cycle in the two groups in treatment group, average lengths of stay, and average hospitalization expenses of such confinement there was no statistically significant difference, the incidence of ADR and the satisfaction was also no statistically significant difference. The average drug treatment costs reduce461.78yuan2cycle than1cycle group. Drug treatment compliance:good rate was62.50%in two PDCA loop groups; however, the good rate was94.12%in one PDCA loop groups. Drug treatments, medication adherence, differences between the two groups have statistical significance.3.The continous improvement of clinical pharmacist’s path.The "clinical pharmacist’s path table "of chronic obstructive pulmonary disease in "Clinical pharmacist’s path model" after the2version of continuous improvement. Version2patients add domestic situation basic information compared with version1; delete the antiviral drugs in drug treatment options. Starting from the3rd edition, on the third day path listed in the "repeated mission of notes on the key drugs","drug compliance checks" were performed from the third day Admitted to hospital to Out of the hospital.Conclusion:Clinical pharmacists take "clinical pharmacist’s path model" to participate in a critical pathways implementation of COPD. The "clinical pharmacist’s path model" will be completed by pharmaceutical ward rounds, the doctor’s advice, pharmaceutical care, medical education, adverse drug reactions monitoring and compliance supervisor check thoroughly as the clinical pharmacy work. That reduces the drug treatment, improves adverse drug reaction monitoring and disposal, improves the patients’ medication compliance and satisfaction, and embodies the value of clinical pharmacists; both give standards for clinical pharmacists to participate in the work pattern of critical pathways implementation.