中国药物警戒 ›› 2022, Vol. 19 ›› Issue (9): 1009-1014.
DOI: 10.19803/j.1672-8629.2022.09.16

• 安全与合理用药 • 上一篇    下一篇

药师参与华法林抗凝治疗对临床安全性和有效性的Meta分析

温都苏1,2, 孙建军3, 王毅3,*   

  1. 1内蒙古国际蒙医医院药学部,内蒙古 呼和浩特 010065;
    2内蒙古医科大学药学院,内蒙古 呼和浩特 010052;
    3内蒙古医科大学附属医院药剂科,内蒙古 呼和浩特 010059
  • 收稿日期:2021-02-04 出版日期:2022-09-15 发布日期:2022-09-16
  • 通讯作者: *王毅,男,主任药师,硕导,临床药学。E-mail:fyyjbwangyi@sina.com
  • 作者简介:温都苏,男,在读硕士,主管药师,临床药学。
  • 基金资助:
    国家自然科学基金资助项目(81960770)

Safety and efficacy of participation of pharmacists in warfarin anticoagulation therapy:a Meta-analysis

WEN Dusu1,2, SUN Jianjun3, WANG Yi3,*   

  1. 1Department of Pharmacy, Inner Mongolia International Mongolian Hospital, Hohhot Inner Mongolia 010065, China;
    2School of Pharmacy, Inner Mongolia Medical University, Hohhot Inner Mongolia 010052, China;
    3Department of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, Hohhot Inner Mongolia 010059, China
  • Received:2021-02-04 Online:2022-09-15 Published:2022-09-16

摘要: 目的 评价药师主导的抗凝模式与其他抗凝模式对临床结果的影响。方法 检索PubMed、Embase、Cochrane Library数据库,收集关于药师主导的抗凝模式与医师或护士主导的抗凝模式比较的研究,检索日期为建库至2020年4月13日。终点事件包括目标治疗范围内的时间百分比(TTR)、出血以及血栓形成事件。结果 共纳入23个研究,包含10 772例患者。结果显示药师主导的抗凝模式较其他模式能显著降低总出血、小出血和血栓事件的发生率,而TTR和大出血事件在2组间无显著差异。按照干预类型进行亚组分析,结果显示药师主导的模式较医师主导的模式能够显著降低患者总出血、小出血和血栓形成事件的发生率。结论 与其他抗凝管理模式比较,药师主导的抗凝模式具有较好的安全性和有效性。

关键词: 华法林, 抗凝药物, 药师, 抗凝管理模式, Meta分析

Abstract: Objective To assess the impact of the pharmacist-managed anticoagulant therapy on clinical outcomes compared with other models. Methods PubMed, Embase and Cochrane Library were searched for related literature published from inception to April 13, 2020. The pharmacist-led anticoagulation model was compared and contrasted with doctor- or nurse-led anticoagulation models. Endpoint events included the percentage of time within the target therapeutic range (TTR), bleeding events, and thrombotic events. Results A total of 23 studies involving 10 772 patients were included. The pharmacist-managed anticoagulation model could significantly reduce total bleeding and the incidence of minor bleeding and thrombosis compared with other models. According to sub-set analysis by types of intervention, the pharmacist-led group could reduce total bleeding and the incidence of minor bleeding and thrombosis more significantly than the physician-led group. Conclusion The pharmacist-managed anticoagulation model is safer and more effective than other anticoagulation models.

Key words: warfarin, anticoagulants, pharmacist, anticoagulation model, Meta-analysis

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