儿童分剂量药学门诊服务模式构建与运行实践

The mode and practice of manipulation in pharmacist-managed clinics for Pediatric

关键词:  儿童  药学门诊  分剂量

Key words:  children  pharmacist-managed clinics  manipulation

摘要:

目的 积极探索儿童分剂量药学门诊服务模式，规范服务内容，解决国内儿童专用药品短缺导致儿童使用成人药品“剂量靠猜、用药靠掰”的难题。方法 建立儿童分剂量药学门诊服务模式和分剂量药学门诊的工作制度。并收集2023年11月至2024年10月分剂量药学门诊就诊患儿，分析分剂量药品品种、药品剂型、分剂量药品规格、分剂量药品数量及就诊次数。结果 调查分剂量药学门诊挂号（21元/次）就诊人次共269。分剂量药品品种共24种，排名前三的药品分别为熊去氧胆酸（占比32.66%）、美托洛尔（12.79%）和氯硝西泮（10.10%）；最常分剂量剂型和极性分别为片剂（90.36%）和脂溶性药品（92.77%）；分剂量药品规格主要是1/5-1/10（45.12%），单次就诊分剂量药品数量主要为1种（91.08%），有一半患儿分剂量药学门诊就诊次数超过1。结论 研究结果显示，处方分剂量在儿科临床中极为普遍且需求量大。我院基于分剂量药学门诊探索儿童药学门诊可持续化发展方向，规范化、标准化儿童分剂量药学门诊服务内容和服务流程，对提高儿童用药安全性、有效性和依从性，降低药品浪费和不良反应发生率具有重要意义。

Abstract:

OBJECTIVE To actively explore the model of manipulation in pharmacist-managed clinics(PMC) for pediatric, standardize service content, and solve the problem of "dose guessing and medication breaking" in the use of adult drugs by children due to the shortage of specialized drugs for children in China. METHODS Establish the service model and working system for manipulation in PMC for Pediatric. Collecting children who visited the manipulation in pharmacist-managed clinics from November 2023 to October 2024, analyze the types, dosage forms, specifications, quantity of manipulated drugs and the number of visits for PMC. RESULTS In this research, there were a total of 269 registered visits to the PMC. There are a total of 24 types of manipulated drugs, with the top three drugs being ursodeoxycholic acid (32.66%), metoprolol (12.79%), and clonazepam (10.10%); The most common dosage forms and formulations are tablets (90.36%) and liposolubility drugs(92.77%), respectively; The specifications of manipulated drugs mainly range from 1/5 to 1/10 (45.12%), and the number of manipulated drugs in a single visit is mainly one ( 91.08%). Half of the pediatric patients have visited the manipulation in PMC more than once. CONCLUSION The results of this study indicate that manipulation are extremely common and in high demand in pediatric clinical practice. Our hospital is exploring the sustainable development direction of PMC based on manipulation. Standardizing the service content and process of manipulation of PMC for pediatric is of great significance for improving the safety, effectiveness, and compliance of pediatric medication, reducing drug waste and adverse reaction rates.