团体标准T/HENANPA027-2025 冠心病住院患者药学监护服务规范 PharmaceuticalCareservicespecificationsofinpatientswithcoronary heartdisease （文件类型：发布稿） 2025－08－15发布 2025－09－01实施 河南省药学会发布 全国团体标准信息平台 I目次 前言...............................................................................................................................................III 引言..............................................................................................................................................IV 1.范围5 2.规范性引用文件............................................................................................................................5 3.术语和定义....................................................................................................................................6 3.1多学科联合诊疗Multi-disciplinaryTeam........................................................................6 3.2冠状动脉粥样硬化性心脏病CoronaryAtheroscleroticHeartDisease...........................6 3.3临床药师ClinicalPharmacist............................................................................................6 3.4药历PharmaceuticalRecord..............................................................................................6 3.5药品不良反应AdverseDrugReaction..............................................................................6 3.6药物重整MedicationReconciliation.................................................................................6 3.7药物-药物相互作用Drug-DrugInteraction......................................................................7 3.8药学病例讨论PharacyCaseDiscussion...........................................................................7 3.9药学查房PharmaceuticalWardRound.............................................................................7 3.10药学服务PharmaceuticalService...................................................................................7 3.11药学会诊PharmaceuticalConsults..................................................................................7 3.12药学监护PharmaceuticalCare........................................................................................7 3.13药学监护分级PharmaceuticalCareClassification.........................................................7 3.14药学监护计划PharmaceuticalCarePlan........................................................................7 3.15药学评估PharmaceuticalEvaluation..............................................................................8 3.16用药教育PatientEducation.............................................................................................8 3.17用药依从性MedicationAdherence.................................................................................8 4.冠心病住院患者药学监护服务流程图.......................................................................................8 5.冠心病住院患者药学监护服务过程.........................................................................................10 5.1用药相关信息收集...........................................................................................................10 5.2初始用药评估...................................................................................................................10 5.3制定药学监护计划...........................................................................................................10 5.4药学监护计划要点...........................................................................................................10 5.4.1用药安全性监护....................................................................................................10 5.4.2用药有效性监护....................................................................................................12 全国团体标准信息平台 II5.4.3特殊人群监护........................................................................................................13 5.4.4特殊合并症人群监护............................................................................................13 5.4.5用药经济性监护....................................................................................................15 5.4.6用药依从性监护...................................................................................