Abstract
The usefulness of protocol based pharmacotherapy management (PBPM) for optimizing lipid emulsion infusion rates in patients receiving total parenteral nutrition (TPN) was evaluated. Adult patients who received TPN for at least 7 days and were administered lipid emulsions at Sainokuni Higashi-Omiya Medical Center were included in this study. The achievement rates of appropriate lipid emulsion infusion rates were compared between the pre-intervention period (November 2024 to April 2025) and the post-intervention period (May 2025 to October 2025). A total of 6 patients in the pre-intervention group and 29 patients in the post-intervention group received lipid emulsions. The achievement rate of appropriate infusion rates improved from 33.3% (2/6 patients) before PBPM implementation to 100% (29/29 patients) after implementation (p8lt;0.001). In addition, PBPM was implemented in 86.2% (25/29 patients) of patients receiving lipid emulsions. No significant deterioration in aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels was observed. The rate of lipid emulsion use increased from 14.3% in the pre-intervention period to 46.8% in the post-intervention period (p8lt;0.001). These findings suggest that the implementation of PBPM enabled standardized management of lipid emulsion infusion rates based on a protocol agreed upon by physicians and pharmacists, thereby promoting the optimization of lipid emulsion infusion practices.
