[课件]王卓-哮喘和copd的药学监护(讲义).pptVIP

哮喘和慢性阻塞性肺病的药学监护 王 卓 药学监护的理解与回顾 实施药学监护的标准模式 临床药师提供的药学监护 哮喘患者药学监护要点 COPD患者药学监护要点 药学监护的理解与回顾 pharmaceutical care 药学监护来源于美国，国内又称药学服务。 其核心思想是通过药师与临床医护人员共同协作，为病人提供直接负责的药物治疗，并积极监测治疗的全过程，以改善病人的治疗效果，最终提高病人的生活质量为目标。 药学服务的目的 获得改善病人生活质量的既定结果。 包括： ① 治愈疾病； ② 消除或减轻症状； ③ 阻止或延缓疾病进程； ④ 防止疾病或症状的再次发生。 Introduction Pharmaceutical Care The direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life (ASHP Statement on Pharmaceutical Care) What a pharmacist does to improve patient care and patient safety Pharmaceutical Care A patient-centered practice Practitioner assumes responsibility for a patient’s drug related needs Practitioner is held accountable for the care provided 工作开展 药学监护是药师在临床疾病治疗中参与并主导的一种工作过程，是多学科协作综合地考虑整体诊疗计划的前提下，从药学角度对治疗计划进行合理的设计、执行、监测和及时调整，实施过程需要患者和医护人员紧密协作。 工作职责 药师对治疗结果负责至少表现为以下三个方面： ① 发现潜在的或实际存在的用药问题； ② 解决实际发生的用药问题； ③ 防止潜在的用药问题发生。 药学监护与药物治疗 药物治疗是临床治疗的主要方式之一 药物治疗是多学科协作的临床服务 药学监护是优化药物治疗的主要手段 药学监护是临床药师的工作核心 实施药学监护的标准模式 ASHP guidelines on a standardized method for pharmaceutical care. Am J Health-Syst Pharm. 1996; 53:1713–6. Functions of Pharmaceutical Care ? Collecting and organizing patient-specific information, ? Determining the presence of medication-therapy problems, ? Summarizing patients’ health care needs, ? Specifying pharmacotherapeutic goals, ? Designing a pharmacotherapeutic regimen, ? Designing a monitoring plan, ? Developing a pharmacotherapeutic regimen and corresponding monitoring plan in collaboration with the patient and other health professionals, ? Initiating the pharmacotherapeutic regimen, ? Monitoring the effects of the pharmacotherapeutic regimen, and ? Redesigning the pharmacotherapeutic regimen and monitoring plan. Collecting and Organizing Pertinent Patient-Specific Information Determining the Presence of Medication-Therapy Problems ? Medications with no medical indication, ? Medical conditions for which there is no medication prescribed, ? Medications pre