ABSTRACT
Objective To evaluate the effectiveness of anticoagulation management by physician-clinical pharmacist team for patients with valvular atrial fibrillation. Methods One hundred and seventy two patients with valvular atrial fibrillation received warfarin therapy for anticoagulation during hospitalization in Linyi People′s Hospital from January 2014 to December 2016, the patients continued to receive warfarin therapy for>6 months after discharge. The patients were randomly assigned in two groups:the anticoagulation management was given by physician-clinical pharmacist team in 87 cases (trial group), while the dosage of wargarin was adjusted in outpatient department by physicians alone in 85 cases (control group). The goal attainment rate of international normalized ratio (INR), the proportion of patients with a stable warfarin dose, knowledge of anticoagulants, belief of medication, medication compliance were compared between two groups. Results There were no significant differences in age, sex, body weight, smoking and drinking habits, valvular disease type, comorbidities; and the initial INR, knowledge of anticoagulants, belief of medication and medication compliance at admission between two groups (all P>0.05). The goal attainment rate of INR (52.17％vs. 41.02％,χ2=8.178, P=0.004), the proportion of patients with a stable dose of warfarin (74.71％ vs. 56.47％,χ2=6.349, P=0.012), the knowledge of anticoagulants (11.03 ± 2.25 vs. 10.08 ± 1.86, t=3.018, P=0.003), the belief of medication[(12.23 ± 2.07) vs. (11.67 ± 1.48), t=2.042, P=0.043], and the medication compliance[(7.36 ± 0.89) vs. (7.04 ± 1.10), t=2.1128, P=0.036] in the trial group were significantly higher than those in control group. Conclusion Anticoagulation management by physician - clinical pharmacist team can improve the management level of anticoagulation and the knowledge of anticoagulans, enhance the medication belief, improve the goal attainment rate of INR and the compliance rate of medication in patients with valvular atrial fibrillation.
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Objective To investigate the prevention of acute kidney injury (AKI) by earlier application of rosuvastatin in patients after coronary artery bypass grafting (CABG).Methods A total of 200 patients with CABG were enrolled from May 2013 to April 2017.According to whether rosuvastatin were used routinely before operation or not,all patients were divided into the trial group (n =136) and the control group (n =64).Demographics,and clinical data were collected before and after CABG.The renal function markers including blood urea nitrogen (BUN),serum creatinine (sCr),endogenous creatinine clearance rate (GFR),emergence of AKI of two groups were documented and compared.Enumeration data were analyzed with x2 test,measurement data were analyzed with t test,and P ＜ 0.05 was considered to be significant.Results There were no differences in sCr (t =-1.156,P ＞ 0.05) but differences in BUN and eGFR (t =-2.915,3.690,respectively,P ＜ 0.05) before operation between two groups.After operation,the BUN was decreased (t =2.486,P ＜ 0.05) compared with that of pre-operation in the trial group,but there were no significant difference in sCr and eGFR (t =-1.877,-0.752,respectively,P ＞0.05).The BUN and sCr were increased (t =-3.792,-5.027,respectively,P ＜ 0.05) after operation compared with that of pre-operation in the control group,while the eGFR was decreased (t =5.540,P ＜0.05).Compared with the control group,BUN,sCr and the incidence of AKI were significantly decreased in the trial group (t/x2 =5.759,4.196,15.506,respectively,P ＜0.05),while the eGFR was increased (t =-6.215,P ＜ 0.05).Conclusions Earlier application of rosuvastatin before CABG can effectively protect renal function and reduce the incidence of AKI.
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OBJECTIVE:To evaluate the effects of clinical pharmacists participating in clinical pathway management for chron-ic heart failure(CHF). METHODS:A total of 107 CHF adult inpatients in Linyi People's Hospital during Jan. 2014-Oct. 2015 were divided into control group(56 cases,3 withdrawal,53 in total)and trial group(58 cases,4 withdrawal,54 in total)accord-ing to random number table. Control group received routine clinical pathway management method of CHF;trial group received clin-ical pathway management with the participation of clinical pharmacists. Clinical efficacy,the utilization of heart failure drugs,eco-nomic indexes,medication compliance after discharge,re-hospitalization rate due to heart failure were compared between 2 groups. RESULTS:Total response rate of trial group was significantly higher than control group,with statistical significance(P0.05). Hospitalization time,drug cost,total hospitalization cost and drug ratio of trial group were short-er or lower than control group,without statistical significance(P>0.05). One month after discharge,the proportion of medication compliance in trial group was significantly higher than control group,with statistical significance(P0.05). Three months after discharge,the proportion of medica-tion compliance in trial group was higher than control group,while re-hospitalization rate was lower than control group,with statis-tical significance(P<0.05). CONCIUSIONS:The participation of clinical pharmacists in clinical pathway management of CHF can significantly improve the utilization rate of recommended drugs by guideline,clinical efficacy and medication compliance,and reduce re-hospitalization rate.
ABSTRACT
Objective To investigate the prevention of acute kidney injury (AKI) by earlier application of rosuvastatin in patients after coronary artery bypass grafting (CABG).Methods A total of 200 patients with CABG were enrolled from May 2013 to April 2017.According to whether rosuvastatin were used routinely before operation or not,all patients were divided into the trial group (n =136) and the control group (n =64).Demographics,and clinical data were collected before and after CABG.The renal function markers including blood urea nitrogen (BUN),serum creatinine (sCr),endogenous creatinine clearance rate (GFR),emergence of AKI of two groups were documented and compared.Enumeration data were analyzed with x2 test,measurement data were analyzed with t test,and P ＜ 0.05 was considered to be significant.Results There were no differences in sCr (t =-1.156,P ＞ 0.05) but differences in BUN and eGFR (t =-2.915,3.690,respectively,P ＜ 0.05) before operation between two groups.After operation,the BUN was decreased (t =2.486,P ＜ 0.05) compared with that of pre-operation in the trial group,but there were no significant difference in sCr and eGFR (t =-1.877,-0.752,respectively,P ＞0.05).The BUN and sCr were increased (t =-3.792,-5.027,respectively,P ＜ 0.05) after operation compared with that of pre-operation in the control group,while the eGFR was decreased (t =5.540,P ＜0.05).Compared with the control group,BUN,sCr and the incidence of AKI were significantly decreased in the trial group (t/x2 =5.759,4.196,15.506,respectively,P ＜0.05),while the eGFR was increased (t =-6.215,P ＜ 0.05).Conclusions Earlier application of rosuvastatin before CABG can effectively protect renal function and reduce the incidence of AKI.