中国临床药学杂志

目的 探讨基于循证药学的多模式用药干预在化疗药物相关恶心呕吐中止吐药物应用的实践效果，为肿瘤化疗患者止吐药物的合理使用提供参考。方法 运用循证药学方法，分析药学干预前后肿瘤化疗患者止吐药物医嘱合理性、呕吐发生率、止吐满意度、生活质量和止吐成本等。结果 药学干预后，患者止吐医嘱合理率、止吐医嘱得分均明显高于干预前（87.06%vs 53.40%,97.61±6.22 vs 86.75±13.40,P <0.01），不同程度缺陷止吐医嘱次数明显减少。患者呕吐发生率明显下降（12.69%vs 28.20%,P <0.01），止吐满意度评分明显升高（98.63±3.75 vs 96.74±5.41, P <0.01）。干预前后患者生活质量得分有所提高，但差异无统计学意义（P> 0.05）。止吐药物成本-效果比明显降低（3.89 vs 5.17）。但在中度呕吐风险中，呕吐发生率和满意度差异无统计学意义。结论 基于循证药学的多模式用药干预，能显著改善肿瘤患者止吐药物的合理使用，减少患者呕吐发生，减轻患者经济负担，值得进一步推广。

AIM To explore the effect of multi-mode medication intervention based on evidence-based pharmacy in rationality of anti-vomiting drugs for treating chemotherapy-induced nausea and/or vomiting(CINV), and to provide reference for anti-vomiting drugs. METHODS The rationality of anti-vomiting medication orders, vomiting incidence,satisfaction with antiemetic treatment, quality of life, anti-vomiting cost in tumor chemotherapy patients were evaluated before and after intervention. RESULTS After pharmaceutical in tervention, the reasonable rate of antiemetic medical advice and average scores were higher than those before the intervention(87.06% vs 53.40%, 97.61±6.22 vs 86.75±13.40,P < 0.01). Antiemetic medical advice defect was significantly less than that before the intervention. Vomiting incidence decreased significantly(12.69% vs 28.20%, P < 0.01), score of satisfaction with antiemetic treatment increased significantly(98.63±3.75 vs 96.74±5.41, P < 0.01). Score of quality of life was improved, but there was no statistical difference before and after intervention(P > 0.05). The cost-effect ratio declined from 5.17 to 3.89. But in the middle risk of vomiting, there was no statistical difference in vomiting incidence and satisfaction. CONCLUSION Multi-mode pharmaceutical intervention based on evidence-based pharmacy can improve rational use of antiemetics in cancer patients, decrease the occurrence of vomiting, and reduce the economic burden of patients. It is worthy of further generalization in hospital.