| Objective:The study was to establish the grading pharmaceutical care pathway in patients with postoperative patient,by studying immunosuppressive agents tacrolimus treatment characteristics,adverse reactions,drug interactions and blood drug concentration monitoring,establishing experiences of pharmaceutical care pathway at home and abroad.In this paper,special case records and case analysis were conducted for the patients with renal inpatient transplantation in our hospital,and the key points of monitoring were summarized.At the same time,the clinical pharmacists were compared and analyzed the effect of pharmacological services on the prognosis of patients after transplantation.We hope to provide the suggestions and methods for clinical pharmacists to participate in the pharmaceutical care for patients after organ transplantation.Methods:Retrieval of patients with Liver/kidney transplant patients our hospital from 2015 to 2016 from the HIS system and combined with literature data,formulate tacrolimus pharmaceutical care program for patients after transplantation.To summarize the adverse reactions,drug interactions,drug combination and therapeutic drug monitoring of the patients after transplantation and establishing tacrolimus pharmaceutical care.Comprehensive analyzed the liver and kidney function,postoperative recovery,disease status and medication regimen etc to assess the patient's medical care level.Set up the primary caring,secondary caring and tertiary caring.The patients were followed up regularly by telephone or WeChat follow-up,and the patients were recorded.According to the patients different levels of standardized pharmaceutical care.The pathways mainly include:Prescription review,drug counseling,medication account and adverse events monitoring etc.Assessed the patient compliance by the Morisky-Green medication compliance evaluation scale and organ transplantation treatment compliance scale.In addition,the patients were selected as the study subjects in our hospital from January to November 2017,and through the screening of patients,they were randomly divided into experimental group and control group.The control group was conventionally treated by physician and nurses.On the basis of the control group,the experimental group also received the grading pharmaceutical care.According to the pharmaceutical care plan established in the early stage,the patient is supervised by pharmaceutical care.Collected the occurrence of compliance,check the situation and adverse events,the readmission rates and satisfaction etc.The collected data were analyzed by spss20.0 statistical software.The difference was statistically significant if P<0.05.The investigation of the influence of pharmacological monitoring on patients after out-patient transplantation.Results:In this article,we established the standard of drug care for post-transplatacrolimus patients,combined with adverse reactions,drug interactions,and the drug monitoring.Through comparative study,the intervention of clinical pharmacists significantly improved the patient's medication compliance,regular review and patient satisfaction,and significantly reduced drug errors and readmission treatment rate.Conclusion:The study established the pharmaceutical care pathway for patients with organ transplantation,and proposed a grading pharmaceutical care method for clinical pharmacists to participate in the prognosis of organ transplantation.It is helpful for the training and daily work of the department of nephrology,which will lay the foundation for the development of clinical pharmacists.At the same time,the results showed that the establishment of pharmaceutical care can significantly reduce the medication errors caused by the wrong dosing schedules,and reduce adverse drug reactions or unreasonable use of drugs and other conditions resulting in unplanned readmission,and improve patients satisfaction.What's more,it can improve patient compliance,ensure the safety of medication and improve the quality of life of patients. |
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