Study on the Management Effect of Pharmaceutical Care on Adverse Reactions of Traditional Chinese Medicines in Joint Surgery and Neurology

Kun Qian,Juan Wang,Xue-Mei Gao ,Li-Li Liu,Jie Zhong,Wen-Ming Cao*

1Changle People's Hospital,Weifang 262400,Shandong,China.

Abstract Objective: In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions (ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug reactions and improve the safety of drug therapy.The Joint Surgery Department and the Department of Neurology of Changle County People's Hospital in Shandong province were investigated for the effect of pharmaceutical care on reducing adverse drug reactions.Methods: 120 patients were selected from the Department of Joint Surgery and Neurology,Changle County People's Hospital,Shandong Province from May 2015 to May 2020.According to the random table method,the patients were divided into experimental group (60 cases) and control group (60 cases).Control group: routine drug therapy.Experimental group: pharmaceutical care treatment was carried out jointly,and the incidence of adverse reactions was compared between the two groups.Results: The incidence of adverse reactions in experimental group was lower than that in control group.Conclusion: In general hospitals,pharmaceutical care is effective in reducing adverse drug reactions,which can significantly reduce the incidence of adverse drug reactions.At the same time,this improves the safety of drug treatment,which is worthy of clinical promotion.

Key words: Pharmaceutical care,Adverse reactions,Management effect

Background

The society began to develop,which was accompanied by the continuous progress of health undertakings and people's increasing health awareness.In recent years,adverse drug reactions (ADR) have been reported more and more,which has attracted the attention of the society.The use of drugs is not limited to the prevention and treatment of diseases,which requires the use of drugs in the process of reducing toxic and side effects to ensure drug safety.The medical staff and pharmacists in the general hospital participate in the pharmaceutical care which is carried out to understand the patient's condition in detail.After that,doctors and nurses give scientific and reasonable medication guidance and timely medication consultation to patients,which can reduce the blindness of patients' medication.At the same time,the incidence of adverse reactions during drug use is greatly reduced [1].

Information and methodology

General information

From May 2015 to May 2020,120 patients receiving traditional Chinese medicines treatment in the Department of Joint Surgery and Neurology,Changle County People's Hospital were selected as the subjects of this study,which were divided into the experimental group (60 cases) and the control group (60 cases)according to the random table method.Control group:conventional drug therapy; experimental group:combined pharmaceutical care therapy.The incidence of adverse reactions was compared between the two groups.The causes of adverse reactions were analyzed from the perspective of patients,and pharmaceutical care countermeasures were proposed according to the causes.

Selection criteria: ①Patients approved by the ethics committee of the hospital; ②Patients who sign informed consent voluntarily; ③Patients residing in the county ;Exclusion criteria: ①Patients with consciousness disorders; ②People with mental illness;③ Patients with severe organ tissue injury; ④Allergic to drugs.

Experimental group: Male: 35,female: 25.Age:25-63 years old.Mean age: 42.2±12.2 years.Weight:50.2-78.5kg.Average weight: 34.35±12.36Kg.There were 26 patients with respiratory diseases,17 patients with cardiovascular diseases and 17 patients with urinary diseases.

Control group: Male: 34 cases,Female: 26 cases,Age: 26-64 years old,Mean age: 43.2±13.2 years.Average weight: 34.42±12.22Kg.Weight: 50.5-78.8Kg.There were 25 patients with respiratory system diseases,18 patients with cardiovascular system diseases and 17 patients with urinary system diseases.The general data of the two groups of patients were compared and analyzed,which met the clinical research standards,and they all signed informed consent for medical research.

Method

Control group: Conventional drug treatment,take medicine according to the doctor's advice,and carry on health education to the patient,tell the patient not to take more,do not take less medicine,do not forget to take medicine.

Experimental group: pharmacists and physicians in general hospitals carried out pharmaceutical care treatment.

(1) Information consultation: When patients receive drugs,clinical pharmacists should take the initiative to give medication guidance to ensure that patients can take drugs accurately.Pharmacists should give timely and accurate answers to patients' drug-related questions,which can avoid the occurrence of adverse reactions.

(2) Medication guidance: Physicians and nurses need to tell patients how well they are controlling the disease and how the drug works.As a result,patients'awareness of the importance of drug therapy was improved.In addition,patients should be informed of the possible adverse reactions and the causes of adverse reactions,which can improve the attention of patients to taking medicine.

(3) Medical calendar construction: When a clinical pharmacist first learns about a patient,they should establish a medication calendar.When the medical calendar is established,the clinical pharmacist should understand the patient's disease,his/her own condition,history of drug allergy and family economic conditions.According to the actual situation of the formulation of rational drug use method,rational drug use guidance is implemented,which makes the relevant personnel to do the archiving work of drug history.

(4) Follow-up: For patients discharged from hospital,medical staff should conduct regular telephone follow-up.According to the actual situation of patients,medical staff will come to visit and follow up,which can accurately record the patient's medication feedback.When discharged patients tell the hospital that they have an abnormality,they should be admitted to the hospital for treatment or their pharmacist should talk to them by phone.In view of this situation,clinical pharmacists should implement targeted guidance according to their specific conditions.The comfort level of patients and their satisfaction with medical staff can be improved.

(5) Correct attitude: When clinical pharmacists give instructions to patients,they must have a high degree of responsibility.When a clinical pharmacist gives a prescription,he or she adjusts the drug according to the patient's physical condition.They will inform the family members and patients of the detailed knowledge of medication,and reduce the patients' blindness to medication.

Data from 120 patients are analyzed at the patient's point of view.The causes of adverse reactions are analyzed,and the countermeasures of pharmaceutical care are proposed according to the causes.

Observation indicators

Assessment of adverse reactions: Adverse reactions are analyzed according to the course of medication,method of medication,and type of medication.

Statistical processing

SPSS 19.0 is used for analysis,where counting data is represented by (n,x%).The measurement data are tested by T test.After comparison of clinical research data,the P value range is between 0.00 and 0.05,which shows a significant difference and is of statistical significance.

Results

The incidence of adverse reactions in laboratory group is lower than that in control group.Among the 60 patients,the experimental group shows 5 cases of adverse reactions.Of the 60 patients,15 has adverse reactions in the control group.The case data of all patients are analyzed from the perspective of the patient.The researchers analyzed the causes of adverse reactions and put forward pharmaceutical care countermeasures according to the causes.The adverse reactions are analyzed as follows

Patients have no knowledge of medication.

The reason that patients can choose traditional Chinese medicines and its preparation is that most of them are non-prescription drugs.Many masses come to consult whether the pharmacy of the hospital sells some kind of traditional Chinese medicines.Sometimes,hospitals ask patients if they have all the traditional Chinese medicines in their prescriptions.After inquiring by the staff,it was found that most of the prescriptions known by the patients were spread through the Internet,books,magazines,folk remedies,home inspection or the familiar population,which had not been justified by science [2].Therefore,the adverse reactions caused by patients' abuse,excessive use of drugs and drug misdiagnosis are also more common in patients.

Improper use of frying tools.

Compared with patients decocting traditional Chinese medicines themselves,many patients think that decocting traditional Chinese medicines in hospital is not effective.However,there are often no utensils for decocting traditional Chinese medicines at home,so patients naturally use instruments made of metal,which not only affects the efficacy of the medicine,but also causes adverse reactions easily.The most effective appliances are crockery,pottery and casserole,which can have even heat conduction,mild heat,long heat preservation and stable chemical composition.Metal utensils,such as iron pot and aluminum pot,can easily react with the active ingredients of traditional Chinese medicines.As a result,the liquid of traditional Chinese medicine will change color,and its efficacy will be reduced,which may even cause side effects.At the same time,the lives of patients are affected.For example,tannic acid is contained in hawthorn,which reacts with iron pot to form ferrous tannic acid.When absorbed by the human body,this will cause adverse reactions such as nausea,vomiting and abdominal distension [3].

Improper cooking time.

There are also many patients think that the longer the traditional Chinese medicines are soaked and decocted,the more concentrated the decocted traditional Chinese medicines are and the more active ingredients are.As a result,the effect will be stronger.Of course,the opinion that the patient hold is wrong.The increase of decocting time of traditional Chinese medicines leads to the evaporation of many active ingredients or in the prolonged decocting process,among which the active ingredients are destroyed by high temperature and the efficacy is greatly reduced.

Not paying attention to diet.

When patients use drugs,they must watch their diet,which is commonly known as restricting certain diets.The aim is to improve efficacy and reduce side effects.For example,the tannins contained in tea leaves can affect the absorption of traditional Chinese medicines by the human body.Therefore,when taking medicine,patients should avoid drinking strong tea [4]; Patients suffering from heat disease should avoid chilies when taking heat-clearing cold blood or anti-inflamation drugs to nourish Yin; People suffering from sores,scabies,poisons and itchy skin should not eat foods with fishy smell,such as fish,shrimp,beef or mutton(commonly known as "Fa wu").This restriction of the patient to a specific diet may prevent recurrence of the disease.Most patients tend to ignore this important factor.They do not restrict their diet,which can affect the effect of the medicine,or make the illness worse or develop a new disease.

Medication is not flexible.

Traditional Chinese medicines adhere to the basic traditional Chinese medicines principles in treating the same disease and syndrome,but does not always follow the same prescription.Traditional Chinese medicines will require patients to return to the hospital regularly and adjust the prescription and dosage.Many patients will take the medicine prescribed by a previous expert,which ignores the importance of treating the disease according to the symptoms of traditional Chinese medicines.

If patients take a lot of traditional Chinese medicines for too long,it is easy to cause cumulative toxicity,their body dependence on drugs and other adverse reactions.If the patient takes cinnabar,reduce blood pressure,tranquilize.If patients take it for too long,their digestion,spermatogenesis,cardiovascular and urinary systems will be harmed; If patients take aconitum for a long time,they may suffer from paroxysmal convulsions,muscular rigidity,stiffening of the body,clenched teeth,incontinence of defecation and urine,asphyxia due to spasm of the breath,and then die of failure [5].

Use many prescriptions at the same time.

When some patients become ill,it is not uncommon for them to visit multiple departments or different hospitals in the same hospital on the same day.A doctor in a single department prescribes a patient's prescription,and there is no question of suitability.However,the possibility of unreasonable drug use in patients often occurs when many patients will use the drugs that are prescribed by multiple departments together.It can easily lead to adverse reactions [6].

Discussion

In view of the above reasons,we believe that pharmaceutical services are mainly carried out from the following aspects.

Strengthen the publicity of traditional Chinese medicines related knowledge.

Relevant personnel regularly carry out science popularization of adverse reactions of traditional Chinese medicines and carry out scientific publicity to the masses.At the same time,relevant personnel prevent people from being misled by media reports of adverse reactions.False publicity that violates scientific principles,exaggerates curative effects,conceals toxicity and adverse reactions is prohibited,and one-sided exaggeration of adverse reactions of traditional Chinese medicines should also be prevented.We advocate the correct use of traditional Chinese medicines under the guidance of doctors and pharmacists for both treatment and prevention.At the same time,we avoid the occurrence of phenomena such as the use traditional Chinese medicines without syndrome differentiation,the excessive use of traditional Chinese medicines,and the arbitrary extension of the treatment course for patients [7].

Popularizing drug knowledge.

Regular lectures were held and medical messages were sent to publicize the basic principles of clinical application of traditional Chinese medicines,characteristics of various proprietary traditional Chinese medicines,indications and precautions,classification of common dosage forms,efficacy classification,safety and prevention methods of adverse reactions to doctors and patients [8].

Strictly control drug quality.

Hospitals should strengthen the management of drug quality in pharmacies and prevent the inflow of fake and inferior drugs.Full-time personnel should check the quality of medicines.Meanwhile,according to the pharmacopoeia of the People's Republic of China,the circulation of unqualified traditional Chinese medicines is strictly prohibited.Relevant personnel should check the medicine prone to mildew and moth at any time,and deal with the problems in time [9].

Guide rational use of traditional Chinese medicines.

If traditional Chinese medicines are used properly,it will cure diseases and save lives,which will produce unexpected magical effects.If traditional Chinese medicines are not used properly,the patient will waste money and medicine.In more serious cases,treatment is delayed,which can lead to death.Therefore,doctors and pharmacists should continue to study and research traditional Chinese medicines.Depending on the condition of the patient,the doctor will prescribe the medicine to cure the disease.Before prescribing medicine,doctors should consult with patients about their allergy history,etc.When necessary,doctors should make relevant examinations for patients first,especially for the elderly,children and pregnant women,they should pay more attention to the dosage of medicine.For their own toxic traditional Chinese medicines,patients try not to use or use less.The dispenser should explain clearly the decocting method and taking requirements of traditional Chinese medicines to the patient.