Exploration The Working Mode Of Clinical Pharmacists Participating In Drug Therapy In Nursing Homes

Due to the low standard of medical teams and technical equipment in Chinese nursing homes,The Chinese clinical pharmacists rarely carry out drug therapy in nursing homes.Various national medical reform policies promoting more cooperation between medical institutions and pension institutions,this study is committed to improve the rational drug use of the elderly for pharmaceutical care in the community.Therefore,this subject will explore the working mode,which can be suitable for clinical pharmacists to participate in drug therapy in nursing homes through practice and exploration.Objective: The 2019 Beers Criteria was first used to screen the long-term drug list of the elderly at YHY nursing home(hereinafter referred to as our hospital)from February 1,2018 to March 31,2019.(1)To determine the distribution of potentially inappropriate drug use and the incidence of adverse events among the elderly.(2)To explore the appropriate mode for clinical pharmacists to participate in drug treatment in nursing homes.Methods:(1)First,use the 2019 Beers Criteria screening and statistics of the elderly’s long-term drug listing about the distribution of potentially inappropriate medication.(2)Secondly,The Karch-Lasagna evaluation method was used to calculate the incidence of adverse events in combination with the elderly’s inpatient information,test results,imaging data and clinical manifestations.(3)Finally,Combine with the practical basis,design a suitable mode for clinical pharmacists to participate in drug therapy’s work mode in nursing homes,and statistic the results derived from practice after half a year.Results:(1)YHY nursing home and geriatrics department had 4,685 long-term drug lists for758 patients,which 421 patients were equal or greater than 60 years old and 56.81% patients were female.The average age was 79.00±9.09 years old.The top three diseases were hypertension,coronary heart disease and diabetes.(2)The incidence of drug-induced PIM was 28.03%(118/421).The incidence of PIM after drug interaction with disease or syndrome was 9.74%(41/421);The incidence of PIM that should be used with caution in elderly patients was 45.84%(193/421).The incidence of PIM was significantly higher than that of community elderly patients: 13.84%,1.86%and 26.76%,respectively.It is reported that the incidence of drug-related adverse events in elderly patients in the community is 24.5%.The drugs with a higher incidence of adverse events in our hospital were hypoglycemic drugs,antipsychotic drugs,antithrombotic drugs and cardiac glycosides drugs.The research shows that the rational drug used in our hospital needs to be strengthened.(3)The results from practice: the distribution of ADR was 44 cases in the control group and 26 cases in the intervention group(P=0.037,P<0.05).The practice achieved high satisfaction from patients(P=0.057,P>0.05).The overall adaption rate that the physicians takes the advice from the pharmacists was 59.46%(44/74).The overall adoption rate that the nurses takes the advice from the pharmacists was 77.5%(31/40).Conclusion: The distribution of PIM in our hospital is concentrated in the cardiovascular and cerebrovascular system and nervous system.The clinical pharmacists participating in drug therapy in nursing homes can improve the rational use of drugs and can be widely used as well.,and the work route can be widely promoted.