药师参与多学科诊疗的模式探讨及效果评价

李赟; 王立新; 郭阳; 田杰; 刘芳

doi:10.6039/j.issn.1001-0408.2023.12.20

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药师参与多学科诊疗的模式探讨及效果评价

药师与药学服务 | 更新时间：2023-06-26

- 药师参与多学科诊疗的模式探讨及效果评价
- Investigation of the mode of pharmacist participating in multi-disciplinary diagnosis and treatment and effect evaluation
- 中国药房 2023年34卷第12期页码：1515-1519
- 作者机构：
  
  1.北京大学第三医院药剂科，北京　100191
  2.山西医科大学第一医院药学部，太原　030001
  3.北京大学医学部药品评价中心，北京　100191
- 作者简介：
  
  副主任药师，硕士。研究方向：临床药学、医院药学。E-mail：103734502@qq.com
  主任药师，硕士。研究方向：临床药学、循证药学。电话：010-82266682。E-mail：liufang8-111@163.com
- 基金信息：
  
  首都卫生发展科研专项项目(首发2020-1-2031)
- DOI：10.6039/j.issn.1001-0408.2023.12.20
  中图分类号： R95
- 纸质出版日期：2023-06-30，
  
  收稿日期：2022-08-25，
  
  修回日期：2023-04-06，
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李赟,王立新,郭阳等.药师参与多学科诊疗的模式探讨及效果评价 ^Δ[J].中国药房,2023,34(12):1515-1519.

LI Yun,WANG Lixin,GUO Yang,et al.Investigation of the mode of pharmacist participating in multi-disciplinary diagnosis and treatment and effect evaluation[J].ZHONGGUO YAOFANG,2023,34(12):1515-1519.
李赟,王立新,郭阳等.药师参与多学科诊疗的模式探讨及效果评价 ^Δ[J].中国药房,2023,34(12):1515-1519. DOI： 10.6039/j.issn.1001-0408.2023.12.20.

LI Yun,WANG Lixin,GUO Yang,et al.Investigation of the mode of pharmacist participating in multi-disciplinary diagnosis and treatment and effect evaluation[J].ZHONGGUO YAOFANG,2023,34(12):1515-1519. DOI： 10.6039/j.issn.1001-0408.2023.12.20.

摘要

目的

评价药师参与多学科诊疗（MDT）的模式及效果。

方法

计算机检索Cochrane图书馆、PubMed、Embase、中国知网、中国生物医学文献数据库和万方数据，收集药师参与MDT对患者临床结局影响的试验性研究和观察性研究。提取资料和评价质量后，对纳入研究的结果进行描述性分析。

结果

共纳入10项研究，其中3项研究为随机对照试验（RCT），2项研究为非RCT，4项研究为队列研究，1项研究为病例对照研究；共计2 422例患者。有效性方面，药师参与MDT后患者的肿瘤无进展生存期、糖化血红蛋白、再入院率和住院时间等指标均显著改善。安全性方面，药师参与MDT后患者大出血事件发生率显著降低。经济性方面，药师参与MDT后患者与药物相关的住院费用、平均门诊医疗费用总额均显著改善，但医疗费用未见明显改善。人文结局方面，药师参与MDT后患者的依从性结论存在争议。

结论

药师根据自身的药学服务技能和方法，全程化地参与MDT，改善了患者的临床结局，提高了用药的安全性，但在经济性和人文结局方面尚存在争议。

Abstract

OBJECTIVE

To evaluate the mode of pharmacists’ participation in multi-disciplinary diagnosis and treatment （MDT）， as well as the effects of pharmacists’ participation.

METHODS

Retrieved from Cochrane Library， PubMed， Embase， CNKI， CBM and Wanfang database， experimental studies and observational studies on the effects of MDT with pharmacists on clinical outcomes of patients were collected. After data extraction and quality evaluation， the results of included studies were analyzed descriptively.

RESULTS

A total of 10 studies were included， among which 3 were randomized controlled trials （RCT）， 2 were non-RCT， 4 were cohort and 1 was case-control study； there were 2 422 patients in total. In terms of effectiveness， tumor progression-free survival， glycosylated hemoglobin， re-admission rate and length of stay and other indexes were all improved significantly after pharmacists participated in MDT. In terms of safety， the incidence of major bleeding events was significantly decreased after pharmacists participated in MDT. In terms of economy， hospitalization costs and total outpatient expenses were improved significantly after pharmacists participated in MDT， but medical cost was not improved significantly. In terms of humanistic outcomes， there was controversy over the conclusion of patient compliance after pharmacists participated in MDT.

CONCLUSIONS

Pharmacists， based on their own pharmaceutical care skills and methods， actively participate in MDT throughout the process， improving the clinical outcomes of patients and enhancing the safety of medication. There are still controversies regarding economic and humanistic outcomes.

关键词

药师多学科诊疗系统评价参与模式效果

Keywords

multi-disciplinary treatmentsystematic reviewparticipation modeeffectiveness

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