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OBJECTIVE To explore the value of pharmaceutical care for patients with CKD3-5D by resident clinical pharmacists. METHODS Clinical pharmacists in the department of nephrology and three students formed a resident pharmacists team to develop standardized pharmaceutical care procedures(including admission medication reconciliation, doctor's order review, DRPs recognition, pharmaceutical care, medication education, discharge medication reconciliation, etc.) to provide pharmaceutical care for patients with 3-5D chronic kidney disease(CKD). The basic information, disease diagnosis and drug reorganization information of patients admitted to the department of nephrology of our hospital in 2024 were collected. The classification system based on the modified version of the European Foundation for Pharmaceutical Care Network(PCNE) was used to analyze the drug related problems(DRPs) of patients for assessment, intervention and statistical analysis. RESULTS A total of 141 patients were included in this study, and pharmacists found 54 DRPs, with an incidence of 38.3%. Among them, 36 cases(66.67%) were related to the effectiveness of treatment. Clinical pharmacists carried out 60 interventions, and the acceptance and complete implementation rate was 79.63%. The harmfulness grades of the 54 DRPs were as follows: 22 in grade E(40.74%), 16 in grade D(29.63%), 6 in grade C(11.11%), 6 in grade B(11.11%), and 4 in grade F(7.41%). CONCLUSION DRPs in patients with CKD3-5D are relatively common and harmful to some extent. Resident clinical pharmacists can identify and timely solve DRPs in patients with CKD3-5D through standardized pharmaceutical care, and assist physicians to ensure the safety, effectiveness and economy of drug use for patients.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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