整合性器官移植藥事照護門診－文獻回顧與成效分析

Multidisciplinary Pharmaceutical Care in Solid Organ Transplant-Literature Review and Impact Analysis

黃怡甄(Yi-Jen Huang) ； 吳建志(Chien-Chih Wu) ； 黃織芬(Chih-Fen Huang) ； 吳家瑋(Chia-Wei Wu)

《臺灣臨床藥學雜誌》 28卷1期 (2020/01) Pp. 1-9

https://doi.org/10.6168/FJCP.202001_28(1).0001

摘要

隨著國內執行器官移植之案例逐年增加，移植病人術後照護的議題逐漸受到討論及重視。術後繁複的藥品濃度監測、服藥依從性、出院病人用藥教育與副作用評估，一直以來皆是影響器官預後之重要關鍵。回顧國內外藥師參與移植團隊之相關文獻，藥師參與移植團隊可顯著減少用藥相關問題、提升病人服藥依從性，以及提供共病之藥事照護，進而提升相關照護品質。臺大醫院自2019年3月起建立了整合性心臟移植藥事照護門診，藥師發現藥品相關問題共67筆，醫師接受率為97.0%。因藥師的介入共節省32,689元健康保險藥費，平均每一看診人次節省573元健康保險藥費。藉此藥事照護門診的起步，期許未來能建立國內各種器官移植藥師門診模式，以提供病人術後更全面之藥事服務。

關鍵字

器官移植 ； 藥事照護門診 ； 藥事照護

並列摘要

The issue regarding postoperative care for patients receiving solid organ transplantation is being noticed and extensively discussed due to the yearly increase of domestic transplant cases. Elements such as the immunosuppressive drugs level monitoring, patient adherence, medication education, and the evaluation of adverse effects, have been crucial to graft prognosis. According to previous studies, pharmaceutical care in solid organ transplant significantly reduced drug related problems, improved drug adherence and enhanced the care in comorbidities. Furthermore, it can improve the quality of care. Pharmacist-led heart transplant clinic in National Taiwan University Hospital was established in March 2019. So far, total drug related problems found by pharmacists were 67, and the acceptance rate by physician was 97.0%. Pharmacist's interventions yielded a total of 32,689 NTD from drug saving, the average cost saving was 573 NTD per patient. It is expected to establish a standard operating procedure of pharmacy service to provide solid organ transplant patients with a more comprehensive care.

並列關鍵字

Solid Organ Transplant ； Ambulatory Care ； Pharmaceutical Care