Study For The Role Of Clinical Pharmacists’ Intervention On The Rational Application Of Proton Pump Inhibitors In General Surgery Department

Objective: The aim of the research is to study the intervention of clinical pharmacist on the rational use of proton pump inhibitors(PPIs)in general surgery department by conducting pharmacy ward round,pharmaceutical care,medical order review,clinical medication training,and applying Pareto chart and fishbone diagram analysis combined with PDCA cycle to manage the intervention process.Methods: The patients in the control group(536 cases)and the intervention group(538cases)were from the general surgery department of a grade III A hospital from 2018.6-2018.11(control group)and 2019.6-2019.11(intervention group)respectively.The control group used retrospective study,according to the clinician’s diagnosis and treatment,and the pharmacist monitored the adverse drug reactions and reviewed the PPIs prescriptions monthly.On the basis of the clinician’s diagnosis and treatment,the intervention group adopted prospective study and conducted clinical pharmacist intervention,including pharmacy ward round,pharmaceutical care,medical order review,clinical medication training,etc.;and combined Pareto chart and fishbone diagram analysis with PDCA cycle to carry out two cycles of intervention.The main outcome indicators were from the overall rational rate of PPIs,the proportion of PPIs use without indication,the utilization rate of PPIs,the average DDDs of PPIs,drug cost,PPIs cost,the cost-effectiveness analysis of clinical pharmacists’ intervention,and the clinical adoption rate.SPSS 23.0 software was used for statistical analysis,and P<0.05 was defined as statistically significant.Result:1 Comparison between the intervention group and the control group: There was no difference in baseline data between the two groups,and they were comparable.The overall rational rate of PPIs in the intervention group was significantly higher than that in the control group(P<0.01);the proportion of PPIs use without indication,the utilization rate of PPIs,the average DDDs of PPIs,drug cost and PPIs cost in the intervention group were significantly lower than those in the control group(P<0.05).From the hospital point of view,the cost-effectiveness ratio and incremental costeffectiveness ratio of the intervention group in improving the overall reasonable rate of PPIs are lower than the cost-effectiveness ratio of the control group,which is of positive economic significance.2 Comparison between the two cycles in the intervention group: There was no difference in baseline data between the two cycles,and they were comparable.The overall rational rate of PPIs and the clinical adoption rate in the second cycle were significantly higher than those in the first cycle(P<0.05),and the proportion of PPIs use without indication was significantly lower than that in the first cycle(P<0.05).There were no significant differences in the utilization rate of PPIs,the average DDDs of PPIs,drug cost and PPIs cost in the two cycles of the intervention group(P>0.05).Conclusion: The intervention of clinical pharmacists on the rational use of PPIs in general surgery department could significantly increase the overall rational rate of PPIs and clinical adoption rate,and reduce the proportion of PPIs use without indication,the utilization rate of PPIs,the average DDDs of PPIs,drug cost and PPIs cost.The costeffectiveness analysis suggests that pharmacists’ intervention was economical to improve the PPIs overall rational rate.