• 作者：Jé ; rô ; me Ployé ; ^a ; ^b ; Franç ; oise Raffy^a ; ^b ; Auré ; lie Malgras^b ; ^e ; Nicolas Reibel^b ; ^c ; Yannick Fuhrer^b ; ^c ; Gilles Grosdidier^b ; ^c ; Pierre Labrude^d ; Michè ; le Labrude^a ; ^b ; Didier Quilliot^b ; ^e ; ^f ; ^{d.quilliot@chu-nancy.fr}
• 关键词：Nutrition parenté ; rale ; Chirurgie digestive ; Prescription nominative
• 刊名：Nutrition clinique et metabolisme
• 出版年：2012
• 期刊代码：123_09850562
• 类别：abs
• 出版时间：June, 2012
• 卷：26
• 期：2
• 页码：59-64
• 文件大小：490 K

Objective

Measure the impact of setting up a support to medical prescriptions allowing the prescriber to precisely target the indications for parenteral nutrition (PN) in digestive surgery department, and following European and French recommendations on the matter. Measure how increasing pharmacist's role impacts both the frequency and quality of prescriptions.

Patients and methods

A prospective study in two periods, each of one month, with analysis of the prescriptions for PN before (group 鈥渂efore鈥? n = 34) and after (group 鈥淎fter鈥? n = 20) the set-up of these medico-pharmaceutical actions.

Results

Patients characteristics were not significantly different in the two groups (mean age was 60 卤 18.1 years vs. 66.6 卤 14.1 years and mean Body Mass Index [BMI] was 28.4 卤 8.2 kg/m² vs. 24.5 卤 4.5 kg/m² in group Before and After respectively). We observed: (1) a significant decrease in the frequency of the PN prescriptions: 11.7%of the hospitalized patients during the first period vs. 6.9%during the second period (P < 0.05); (2) a decrease in the peripheral PN (23.5%for G Before vs. 5%for G After), and a significant increase in the central PN (41.2%for G Before vs. 90%for G After; P = 0.0004); (3) 32.3%of patients (G Before) systematically received a complete supplementation against 90%for G After (P = 0.0002), signing the improvement in the quality of the prescriptions; (4) an economy of 39%was done due to these actions.

Conclusion

This study demonstrates the impact of setting up a nominative prescription and of a quality control check by the pharmacists on the PN prescription. These results justify and prove the efficiency of the medico-pharmaceutical actions undertaken. Both the medical as well the economical impact of these measures should allow the financing of 鈥減harmacist-time鈥?in order to extend such a PN prescription and follow-up mode to all services of the hospital.