Analysis of clinical effect of involvement of clinical pharmacists in perioperative total parenteral nutrition prescription for cancer patients / 中华临床营养杂志

ABSTRACT

Objective To evaluate the effect of the intervention of involving clinical pharmacists in perioperative total parenteral nutrition (TPN) prescription,including rationality of prescriptions,the length of hospital stay and economic evaluation.Methods We respectively selected TPN prescriptions in September to November 2015 (pre-intervention) and December 2015 to February 2016 (post-intervention) from a surgery department of Harbin Medical University Cancer Hospital.The data regarding rationality of prescription,length of hospital stay,and economic benefit were analyzed in order to evaluate the effect of involvement of clinical pharmacists in TPN prescriptions.Results A total of 81 patients with 115 TPN prescriptions before the intervention and 92 patients with 124 TPN prescriptions after the intervention were recruited.Through comparative analysis,the rationality of TPN prescriptions increased significantly after the participation of clinical pharmacists in terms of the rational glucosefat ratio,energynitrogen ratio,electrolyte concentration,and the choice of vitamin preparations;and the utilization of controversial treatments such as invert sugar and other drugs into readyto-use TPN solution was decreased significantly;average daily cost of TPN was decreased from (1 021 ± 218) yuan to (860 ± 176) yuan (P ＜0.001);average duration of hospital stays was decreased but the difference was not statistically significant (P ＞ 0.05).Compared with the data before the intervention,serum albumin levels after the intervention showed no statistically significant difference but pre-albumin levels were significantly higher after the participation of clinical pharmacists [(175.0 ± 77.9) g/L vs.(153.2 ± 64.8) g/L,P ＜ 0.05].The liver and kidney function indicators showed no statistically significant differences between pre-and post-intervention (P ＞ 0.05).Conclusion Engaging clinical pharmacists in TPN prescription can improve prescription rationality,ensure clinical drug safety,reduce the daily cost of nutrition treatment and thus reduce the economic burden of patients.