1.Establishment and application of a precise management model for the centralized preparation of cytotoxic drugs in PIVAS
Shuai LIU ; Daiyi LI ; Jinhuan SU ; Shangjun GU ; Ningbo MOU ; Yunli ZHOU ; Yan LAI
China Pharmacy 2025;36(19):2437-2441
OBJECTIVE To establish the precise management model for the centralized preparation of cytotoxic drugs in pharmacy intravenous admixture services (PIVAS), and evaluate the effects of its application. METHODS Pharmacists in PIVAS established the precise management model by soliciting clinical opinions and consulting literature on the centralized preparation of cytotoxic drugs and continuously refining every step of the preparation of cytotoxic drugs, based on data feedback from the information closed-loop management system and the limit of stability time of finished solutions. The indicators such as the preparation time, delivery time, the storage time of finished infusion solutions after preparation, and the completion rate of infusion within the stability time limit were analyzed before the implementation (January to December 2023) and after the implementation (January to December 2024) of this model, to evaluate its application effectiveness. RESULTS The overall framework for the precise management model included upgrading the functions of the prescription review system, improving the prescription review database, providing specialized training for PIVAS pharmacists, managing dynamic batch decision for drug preparation, managing special drugs, managing finished infusion distribution, and establishing a continuous improvement mechanism. Compared with before implementation, the average preparation time of the second and third batches of cytotoxic drugs with more concentrated morning preparation tasks in this model was significantly shorter than before implementation (P<0.05); the delivery time of finished infusion after implementation ([ 11.49±2.92) min] was significantly shorter than the delivery time before implementation ([ 22.11±5.03) min] (P<0.001); the storage time of some drugs with shorter stable time limit and carboplatin in combination regimens (paclitaxel or docetaxel+carboplatin) was significantly shortened compared to before implementation (P<0.05), and the completion rate of infusion within the stability time limit was significantly improved compared to before implementation (P<0.05). CONCLUSIONS Our hospital has successfully established a precise management model for the centralized preparation of cytotoxic drugs in PIVAS. This mode can significantly shorten the preparation time of each batch of PIVAS in the morning, make batch decisions more reasonable and improve the infusion completion rate within the stable time limit of the finished product.
2.Study on the Knowledge-Attitude-Practice questionnaire for patients receiving oral anticoagulant therapy based on the Delphi method
Xiaomei LEI ; Na WANG ; Qiao LING ; Xinting ZHU ; Sha QIU ; Daiyi LI ; Yan QIAN
China Pharmacy 2024;35(10):1260-1265
OBJECTIVE To develop a questionnaire of the Knowledge-Attitude-Practice (KAP) for patients receiving oral anticoagulant therapy. METHODS Under the guidance of the theory of KAP, literature analysis and interview method were used to design the initial KAP questionnaire for patients treated with oral anticoagulants. Delphi method was adopted to consult the initial questionnaire and modify the questionnaire based on expert suggestions to form the final questionnaire. RESULTS Two rounds of consultation were conducted with 18 experts, and 18 questionnaires were sent out and recovered in each round, so the positive coefficient of experts was 100%. The expert authority coefficient was 0.94. The average importance scores for all dimensions, factors, and items of the questionnaire in both rounds were ≥4 points. The coefficient of variation was ≤0.25. The Kendall’s concordance coefficient for the overall questionnaire and the three dimensions of knowledge, attitude, and practice ranged from 0.09 to 0.34 (all P<0.05). Following the first round of expert consultation, four items were modified, two items were deleted, and five items were added; after the second round of expert consultation, ten items were modified. The final version of the questionnaire included three dimensions (knowledge, attitudes, and practice), 17 questionnaire factors, and 40 items. CONCLUSIONS The questionnaire has high reliability and scientific validity with relatively concentrated expert opinions. It is suitable for assessing the knowledge, attitudes, and practice status of patients receiving oral anticoagulant therapy.
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