Study on the service intervention of medication therapy management for outpatient children with epilepsy_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Zhe ^1,2,3,4 , LIN Mao ⁵ , NI Xiaofeng ^1,2,3,6 , GAN Jing ⁷ , LUO Rong ⁷ ,  HUANG Liang ^1,2,3 , ZHANG Lingli ^1,2,3

1. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, P.R.China;
3. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu 610041, P.R.China;
4. West China School of Pharmacy, Sichuan University, Chengdu 610041, P.R.China;
5. Department of Pharmacy, Sichuan Cancer Hospital & Institute, Chengdu 610041, P.R.China;
6. West China School of Medicine, Sichuan University, Chengdu 610041, P.R.China;
7. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

HUANG Liang, Email: hliang_1022@163.com

Keywords：

Epilepsy; Children; Outpatient; Intervention; Medication therapy management

DOI：

10.7507/1672-2531.202107070

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Objective To explore the service contents of medication therapy management (MTM) for outpatient epileptic children by analyzing drug related problems (DRPs). Methods A cross-sectional study was adopted to analyze the status of DRPs in outpatient epileptic children in West China Second Hospital of Sichuan University. The focus group discussion method was adopted to formulate the specific service contents of MTM in outpatient epileptic children. Results A total of 2 754 cases of antiepileptic drug treatment were received in the pediatric clinic of West China Second Hospital of Sichuan University from October 1^st, 2018 to December 31^st, 2018, including 2 018 cases of monotherapy and 736 cases of combination therapy, involving 7 drugs and 10 specifications. The specifications in descending order of frequency of drug use were levetiracetam oral solution, levetiracetam tablets, sodium valproate oral solution, oxcarbazepine oral suspension, oxcarbazepine tablets, topiramate capsules, sodium valproate sustained-release tablets, lamotrigine tablets, magnesium valproate sustained-release tablets and carbamazepine tablets. We applied the Pharmaceutical Care Network Europe (PCNE) classification and found 718 DRPs, mainly focusing on drug selection and improper course of treatment. The specific service contents of MTM for children with epilepsy in the clinic included hospital pharmacy information services, medical teams established by pharmacists, doctors and nurses, child education and medication consultation, and medication follow-up for discharged children. In addition, specific measures to solve DRPs in outpatient epileptic children were designed from 2 aspects of disease management and medication education, and 3 aspects of drug prescription, dispensing, and usage. Conclusions There are various types of antiepileptic medications and treatment schemes for children, and DRPs are complicated. Therefore, MTM for children with epilepsy requires to be strengthened. In this study, the specific intervention contents of MTM for outpatient epileptic children are designed to carry out the follow-up empirical study to verify the effectiveness of MTM.

Citation： CHEN Zhe, LIN Mao, NI Xiaofeng, GAN Jing, LUO Rong, HUANG Liang, ZHANG Lingli. Study on the service intervention of medication therapy management for outpatient children with epilepsy. Chinese Journal of Evidence-Based Medicine, 2021, 21(11): 1241-1246. doi: 10.7507/1672-2531.202107070 Copy

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2.	Pellegrino AN, Martin MT, Tilton JJ, et al. Medication therapy management services: definitions and outcomes. Drugs, 2009, 69(4): 393-406.
3.	林茂, 陈哲, 曾力楠, 等. 国内, 外药物治疗管理文献研究现状分析. 中国药房, 2019, 30(17): 2305-2310.
4.	McGivney MS, Meyer SM, Duncan-Hewitt W, et al. Medication therapy management: its relationship to patient counseling, disease management, and pharmaceutical care. J Am Pharm Assoc, 2007, 47(5): 620-628.
5.	U. S. government information. Affordable care act, 2010. Avaiable at: https://www.hhs.gov/healthcare/about-the-aca/index.html.
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7.	杨陈, 张学兵. 慢性疾病儿童照顾者照护负荷研究进展. 护士进修杂志, 2018, 33(11): 992-996.
8.	Benavides S, Madzhidova S, Hernandez A, et al. Establishment of pediatric medication therapy management: a proposed model. Pharmacy (Basel), 2016, 4(1): 5.
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11.	常琳, 王小姗. 中国癫痫流行病学调查研究进展. 国际神经病学神经外科学杂志, 2012, 39(2): 161-164.
12.	单晓光, 陈荣华, 邓静云, 等. 江苏省0~14岁儿童癫痫流行病学调查. 南京医学院学报, 1992, (2): 170-172.
13.	王家良. 临床流行病学. 中华医学杂志, 1998, 12: 930-932.
14.	Then KL, Rankin JA, Ali E. Focus group research: what is it and how can it be used. Can J Cardiovasc Nurs, 2014, 24(1): 16-22.
15.	Kidd PS, Parshall MB. Getting the focus and the group: enhancing analytical rigor in focus group research. Qual Health Res, 2000, 10(3): 293-308.
16.	Rabiee F. Focus-group interview and data analysis. Proc Nutr Soc, 2004, 63(4): 655-660.
17.	阮忠, 黄敬亨. 专题小组讨论法. 中国健康教育, 1994, 9: 4-5.
18.	Marcus D. The epilepsies: diagnosis and management. Gen Pharmacol-vasc S, 1990, 22(4): 765.
19.	NICE. The epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care. 2012. Available at: https://www.ncbi.nlm.nih.gov/books/NBK247130/.
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22.	张萍, 廖赟, 吕丹, 等. 运用PCNE分类体系对癌痛患者麻醉镇痛药物的处方分析. 中国药师, 2018, 21(6): 1051-1054.
23.	《中国国家处方集》编委会. 中国国家处方集: 儿童版. 北京: 人民军医出版社, 2012.

1. 王可, 侯凯旋, 闫素英. 国内外药物治疗管理开展现状. 中国药房, 2018, 29(5): 580-586.
2. Pellegrino AN, Martin MT, Tilton JJ, et al. Medication therapy management services: definitions and outcomes. Drugs, 2009, 69(4): 393-406.
3. 林茂, 陈哲, 曾力楠, 等. 国内, 外药物治疗管理文献研究现状分析. 中国药房, 2019, 30(17): 2305-2310.
4. McGivney MS, Meyer SM, Duncan-Hewitt W, et al. Medication therapy management: its relationship to patient counseling, disease management, and pharmaceutical care. J Am Pharm Assoc, 2007, 47(5): 620-628.
5. U. S. government information. Affordable care act, 2010. Avaiable at: https://www.hhs.gov/healthcare/about-the-aca/index.html.
6. 彭敏, 章小雷. 慢性病儿童对父母、家庭的影响及相关干预的研究现状和展望. 中国当代医药, 2019, 26(13): 30-33.
7. 杨陈, 张学兵. 慢性疾病儿童照顾者照护负荷研究进展. 护士进修杂志, 2018, 33(11): 992-996.
8. Benavides S, Madzhidova S, Hernandez A, et al. Establishment of pediatric medication therapy management: a proposed model. Pharmacy (Basel), 2016, 4(1): 5.
9. 中国抗癫痫协会. 临床诊疗指南: 癫痫病分册. 北京: 人民军医出版社, 2015.
10. 杨春松, 宋虹漪, 张伶俐, 等. 中国儿童癫痫患者用药依从性现状和影响因素研究. 中国药事, 2017, 31(12): 151-159.
11. 常琳, 王小姗. 中国癫痫流行病学调查研究进展. 国际神经病学神经外科学杂志, 2012, 39(2): 161-164.
12. 单晓光, 陈荣华, 邓静云, 等. 江苏省0~14岁儿童癫痫流行病学调查. 南京医学院学报, 1992, (2): 170-172.
13. 王家良. 临床流行病学. 中华医学杂志, 1998, 12: 930-932.
14. Then KL, Rankin JA, Ali E. Focus group research: what is it and how can it be used. Can J Cardiovasc Nurs, 2014, 24(1): 16-22.
15. Kidd PS, Parshall MB. Getting the focus and the group: enhancing analytical rigor in focus group research. Qual Health Res, 2000, 10(3): 293-308.
16. Rabiee F. Focus-group interview and data analysis. Proc Nutr Soc, 2004, 63(4): 655-660.
17. 阮忠, 黄敬亨. 专题小组讨论法. 中国健康教育, 1994, 9: 4-5.
18. Marcus D. The epilepsies: diagnosis and management. Gen Pharmacol-vasc S, 1990, 22(4): 765.
19. NICE. The epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care. 2012. Available at: https://www.ncbi.nlm.nih.gov/books/NBK247130/.
20. The committee for guidelines of the German society of neurology (DGN). Guideline first epileptic seizure and epilepsies in adulthood. Available at: http://www.nice.org.uk/guidance/QS26.
21. 曾晨欣, 王皓, 吴秋惠, 等. 药学服务中药物相关问题的研究进展. 中国药房, 2018, 29(16): 2291-2295.
22. 张萍, 廖赟, 吕丹, 等. 运用PCNE分类体系对癌痛患者麻醉镇痛药物的处方分析. 中国药师, 2018, 21(6): 1051-1054.
23. 《中国国家处方集》编委会. 中国国家处方集: 儿童版. 北京: 人民军医出版社, 2012.

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