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As important evidence of patients’ medication, the rationality of prescription is directly related to the outcome of patients’ disease. To ensure the rationality of the prescription, it is necessary to find and correct the inappropriateness of the prescription as far as possible, such as mismatch, inappropriate and unnecessary treatment[15], and possible errors, including serious prescription errors caused by inattention or the prescription’s failure to apply the relevant rules[16]. In addition to the rationality of the prescription, monitoring adverse drug events is also the key point affecting the safety of patients’ medication, such as the use of computer technology to monitor adverse events of inpatients, which has made a great positive contribution to reducing the occurrence of adverse events of patients[17].
Pharmacists’ evaluation and control of prescription rationality, the investment in cost can be said to be negligible [18], but its role is quite valuable. For instance, affected by the aging and pathological changes of physical function, the elderly often uses drugs in combination, and the examination of multi-drug prescriptions requires solid and reliable pharmaceutical professional knowledge [19]. Therefore, the role of pharmacists in dealing with inappropriate prescriptions is particularly prominent in the use of drugs for the elderly[19]: Using pharmacists to evaluate the use of drugs, it was found that the incidence of diseases caused by the combination of drugs in elderly cancer outpatients may be related to inappropriate drug use[20]; a randomized controlled trial of clinical drug review conducted by pharmacists against routine practice shows that pharmacists can effectively recheck repeated prescriptions issued by general practitioners, change the use of drugs in elderly patients, and save medical expenses [21]; in the trial of medication effect on the elderly in Quebec, it was found that pharmacist-led educational intervention could interrupt inappropriate drug use, and the interruption effect was better than that of routine nursing[22]. However, not all studies under the intervention of pharmacists have positive results. For example, in a study on medication errors in patients after discharge, although pharmacists are involved, the results suggest that this intervention does not significantly reduce such errors [23].
On the premise of ensuring the rationality of the prescription, controlling the occurrence of adverse drug events (ADE) is an important issue to ensure the safety of drug use. Pharmacists’ reduction in the risk of adverse drug events, such as cardiovascular events [24], has shown a significant impact on public health: The study assessed the physical condition of 723 patients recruited at 3 months and found that cardiovascular risk and measurements of biochemical indicators such as low density lipoprotein cholesterol, systolic blood pressure and glycosylated hemoglobin in the intervention group were significantly lower than those in the routine care group [24]; and with proper education and training, pharmacists can correctly and reasonably evaluate and intervene penicillin allergy and guide the whole process of skin testing[25]. Especially during the treatment of drugs with serious adverse reactions, such as those used in intensive care units. A study assessed the participation of pharmacists in ICU and found that after the intervention, the incidence of adverse drug events (ADE) decreased more significantly, by 66%, and about 99% of the recommendations made by pharmacists related to drug ordering were accepted by doctors [26].