薬剤管理指導業務の必要性と質的および量的拡大に関する研究

Abstract

Pharmaceutical care for inpatients has been established as one of main duties of hospital pharmacists. It is therefore necessary to demonstrate the advantages of such care.Sasaguri Hospital has 3 different types of wards, one for the treatment of acute diseases, one for the longterm stay of elderly patients, and one for the provision of psychotherapeutic care. The percentage of inpatients receiving pharmaceutical care in the hospital has averaged about 99.6% of since October 2001. This report describes the results of such pharmaceutical care in Sasaguri Hospital.In 2000, the percentage of inpatients for whom drug information was offered from pharmacists to donors, was about 22% in the general ward for the treatment of acute diseases, but this rate was even higher in the other wards. In 2001, the percentages in the long-term stay and psychotherapeutic wards increased in comparison to the results of the previous year.The percentages of “pre-avoid” reports (pharmaceutical report of early detection of or avoidance of adverse drug reactions) among inpatients cared for by pharmacists in the general ward, the long-term stay ward, and the psychotherapeutic wards were 0.53%, 0.62%, and 0.42%, respectively. The number of “pre-avoid” reports increased with the increase in pharmaceutical care in all wards. These results demonstrate that appropriate pharmaceutical care is essential to ensure the adequate risk management of drug therapy.The number of insurance claims for pharmaceutical care per inpatient in the general ward, was smaller than that is the long-term stay or psychotherapeutic wards. In addition, the number of times that pharmaceutical advice was given to each inpatient per insurance claim in the general ward, was more than that in the other wards. Therefore, in the general ward, in order to increase claims for pharmaceutical care, it is necessary to step up the number of inpatients cared for by pharmacists, and to begin such care as soon as possible after admission.The percentage of inpatients for whom drug information was offered from pharmacists to doctors, the rate of prescription changes, and the number of “pre-avoid” reports during pharmaceutical care. showed no statistically significant differences between the short-term admission group and the long-term admission group in either the long-term stay or the psychotherapeutic ward. These results demonstrate that the necessity of appropriate pharmaceutical care in these wards is totally unrelated to the length of admission.