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OBJECTIVE:To provide reference for pharmacists to participate in the management of chronic disease. METHODS:A total of 259 patients with chronic airway disease [included asthma and chronic obstructive pulmonary disease (COPD)] met the inclusion criteria were selected from our hospital and 5 community health care centers of medical consortium. These patients received medication safety assessment management,which was led by clinical pharmacists of our hospital with the participation of community pharmacists,including medication safety comprehensive evaluation and risk classification management, follow-up and medication guidance, integrated prescriptions checking, establishment of shared database. 1 years after the implementation,the effectiveness were evaluated by score the relatived indicators in related groups. RESULTS:After a year of the management mode practice,compared with before intervention,the patients'safety medication cognitive ability score in high-risk and low-risk group increased from(4.49±1.26)and(7.31±1.01)to(5.40±1.56)and(7.44±0.91);medication adherence score increased from(4.96±1.21)and(7.08±1.24)to(6.66±1.08)and(7.38±0.98);ACT score from asthma patients increased from (16.15±2.58)and(21.15±1.03)to(16.80±2.57)and(21.64±1.55);CAT score from COPD patients decreased from(25.51± 4.07) and (14.90 ± 3.95) to (24.20 ± 3.96) and (13.80 ± 4.08);the rate of irrational prescription effective identification and intervention by pharmacists increased from 3.6％ and 1.4％ to 9.4％ and 7.6％,respectively. All the differences above were statistically significant (P<0.05). CONCLUSIONS:The participation of pharmacists in long-term medication safety assessment management for chronic airway disease patients can improve patients'safety medication cognitive ability,medication adherence, disease control and the pharmacists'ability of irrational drug use identification and intervention.
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OBJECTIVE:To explore the clinical utilization of carbapenems in a hospital,analyze and evaluate its medication rationality. METHODS:All the 508 medical records of inpatients treated with carbapenems from Jul. 2012 to Jun. 2015 were retro-spectively investigated,the utilization and pathogenic examination of carbapenems were evaluated;by setting the carbapenems eval-uating standard,the medication rationality of carbapenems was evaluated and inappropriate cases were classified and analyzed statis-tically. RESULTS:The drug utilization indexed (DUI) of Imipenem and cilastatin sodium for injection and Meropenem for injec-tion were 0.80 and 1.32,respectively;the total rate of microbial inspection was 95.9%;according to the drug sensitive test result, the rate of drug selection was 62.8%;there were 54 cases(10.6%)of irrational use records,in which,irrational dosage(42.6%) and improper drug selection (31.4%) were the major problems. CONCLUSIONS:There are some inappropriate medication prob-lems in carbapenems utilization in the hospital. Developing the carbapenems utilization evaluation is helpful to discover typical medi-cation problems,which can provide reference for intervention and continuous improvement of rational drug use.
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Objective To analyze the behavior of patients with serious adverse drug reactions and look for risk factors leading to serious adverse drug reactions .Methods Patient medication behavior evaluation method was established,which was used in cases of serious adverse reaction caused by stains in recent three years in Beijing Chuiyangliu Hospital .Clinical pharmacists participated in field survey .Medication behavior of patients was analyzed from three aspects of knowledge ,attitude and ability .Results Three patients had serious adverse reactions occurred in recent 3 years,drugs were suspected of simvastatin and atorvastatin .The score of medication knowledge was lower than 20%.The score of health attitude was lower than 20%.The score of taking ability was lower than 20%. Conclusion In the investigation of serious adverse reaction ,pharmacists found the risk behavior of patients with daily medication is an important cause of patients with serious adverse reaction .Pharmacists should strengthen the drug education and publicity ,especially in patients with risk factors of medication behavior such as knowledge ,attitude and ability in their daily work .
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<p><b>BACKGROUND</b>Neoadjuvant chemotherapy is one of the hot points of lung cancer therapy,which has been proven to be able to improve resection rate and 5-year survival of patients.But its effect on operation safety is not clear yet.The aim of this study is to confirm the effect of neoadjuvant chemotherapy on pulmonary arterial wall so as to assess its safety for operation in patients with lung cancer.</p><p><b>METHODS</b>Thirty-two patients underwent lobectomy or pneumonectomy with mediastinal lymphadenectomy after a neoadjuvant chemotherapy,compared with 36 patients surgically treated only.During the operation,the changes of thoracic structure were observed.After the operation,the pulmonary artery specimens were detected pathologically.</p><p><b>RESULTS</b>The incidence of pleural fibrosis and thickening of pulmonary arterial tunica adventitia in neoadjuvant chemotherapy group was significantly higher than those of control group(59.38% vs 22.22%,P < 0.01;68.75% vs 19.44%,P < 0.01).The incidence of tunica intima,internal elastic membrane and tunica media damage in neoadjuvant chemotherapy group was also markedly higher than those of control group(65.62% vs 33.33%,P < 0.01;59.38% vs 19.44%,P < 0.01;71.88% vs 22.22%,P < 0.01).</p><p><b>CONCLUSIONS</b>Neoadjuvant chemotherapy may lead to pleural fibrosis and thickening of pulmonary arterial tunica adventitia and increase crispness of pulmonary arterial wall,which may increase difficulty and risk of operation.</p>
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<p><b>BACKGROUND</b>Bronchioloalveolar carcinoma is a kind of special lung cancer. The aim of this study is to analyze its characteristics, surgical intervention and prognosis.</p><p><b>METHODS</b>Fifty-eight surgically treated patients with bronchioloalveolar carcinoma from 1993 to 2000 were followed up. The clinical characteristics, surgical mode, site of recurrent disease and survival were analyzed.</p><p><b>RESULTS</b>Out of 58 patients, 15 were male (25.9%), and 43 were female (74.1%). Fifty-one patients performed lobectomy ( 87.9%). The 1-, 3- and 5-year survival rate was 91.4%, 75.9% and 60.3% respectively. There was no remarkable difference in survival between chemotherapy group and non-chemotherapy group after surgery (P= 0.22).</p><p><b>CONCLUSIONS</b>Lobectomy is performed commonly in patients with bronchioloalveolar carcinoma. No obvious correlation is found between postoperative chemotherapy and survival.</p>