Construction and evaluation of a perioperative pharmaceutical care model for orthopedic joint replacement
- VernacularTitle:骨科关节置换术围术期药学服务模式构建及评价
- Author:
Ting XIANG
1
;
Yao LIU
1
;
Xue YANG
1
;
Fang LIU
1
;
Xia YANG
2
Author Information
1. Dept.of Pharmacy，Daping Hospital，Army Medical University，Chongqing 400042，China
2. Dept.of Wound Infection and Drugs，State Key Laboratory of Trauma and Chemical Poisoning，Daping Hospital，Army Medical University，Chongqing 400042，China
- Publication Type:Journal Article
- Keywords:
Joint replacement;
Perioperative;
Pharmaceutical care;
DRG payment;
Medication therapy management;
clinical pharmacy specialty collaboration
- From:
China Pharmacy
2026;37(18):2424-2429
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To construct and evaluate a perioperative pharmaceutical care model for orthopedic joint replacement based on clinical pharmacy specialty collaboration and medication therapy management （MTM）， so as to provide a reference for improving the level of clinical rational drug use and reducing medical costs.METHODS Patients undergoing orthopedic joint replacement were taken as the research subjects. A specialized collaboration group was established， consisting of the head of the clinical pharmacy group， ward-based clinical pharmacists， and multi-specialty clinical pharmacists. The practice path， service contents，and workflow of MTM for the perioperative period of orthopedic joint replacement were clarified，and a perioperative pharmaceutical care model for orthopedic joint replacement was developed. Data of patients in the orthopedic diagnosis-related groups （DRG）-IC29 group of the department of orthopedics in Daping Hospital，Army Medical University were collected from July 2022 to June 2023 （pre-intervention， 581 cases） and from July 2023 to June 2024 （post-intervention， 843 cases）. The work-implementation indicators in the post-intervention period were counted， and the efficiency indicators and pharmaceutical management indicators were compared between the pre- and post-intervention periods. Meanwhile，200 patients were randomly selected from the pre-intervention and post-intervention groups， respectively， to evaluate the rate of rational medical orders.RESULTS From July 2023 to June 2024， the collaboration group implemented MTM for 843 patients undergoing orthopedic joint replacement via the established perioperative pharmaceutical care model. A total of 1 163 drug‑related problems （DRPs） were identified， and 79 patients with high medication‑related risks were screened out. The most common types of DRPs included （possible） adverse drug events/reactions （48.93%）， unnecessary drug therapy （21.58%）， and ineffective drug therapy （16.25%）. Among the 1 163 DRPs， 895 （76.96%） were completely resolved. Compared with the pre‑intervention period， the post‑intervention period showed reductions in average hospitalization cost per case， average drug cost per case， average length of hospital stay， proportion of drug cost， utilization rate and use intensity of antibacterial agents， and per‑capita drug cost of six main drug categories. The rate of rational medical orders increased from 78.25% to 98.11%.CONCLUSIONS The perioperative pharmaceutical care model for orthopedic joint replacement based on clinical pharmacy specialty collaboration and MTM can help pharmacists identify and resolve DRPs during the perioperative period of orthopedic joint replacement，improve the level of clinical rational drug use，and reduce treatment costs.
