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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].