ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Enhancing the Rational Use of Sodium Valproate in Neurosurgery: A Pharmacist-Led PDCA Intervention
Zhuoxue Li
Yahao Ling
Guifang Rao
Mengkao Li
Zhili Zhao
Li Gong
Shiqin Dai
Tao Shi
Shenzhen Longhua People's Hospital, Shenzhen, China
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Abstract
Background and Objective: Inappropriate use of sodium valproate (VPA) for seizure prophylaxis in neurosurgery poses clinical risks and increases healthcare costs. This study aimed to evaluate the effectiveness of a clinical pharmacist-led intervention, integrated with the Plan-Do-Check-Act (PDCA) cycle, in optimizing VPA utilization among neurosurgical patients. Methods: This retrospective pre-post study analyzed patients in the Neurosurgery Department of a tertiary hospital who received sodium valproate between July 2022 and December 2024. A multidisciplinary team, led by clinical pharmacists, implemented a PDCA cycle to standardize sodium valproate administration. Key metrics—including irrational drug use, treatment duration, and Defined Daily Doses (DDDs)—were compared pre-and post-implementation. Results: The intervention significantly increased the rational use of sodium valproate from 32.00% to 93.41%. This clinical shift was accompanied by substantial resource optimization, including a reduction in the average duration of injectable therapy (from 8.32 ± 6.44 to 5.37 ± 3.81 days) and a dramatic decline in the DDDs of prophylactic intravenous sodium valproate (from 184.69 ± 50.40 to 17.91 ± 8.92). Furthermore, inappropriate average DDDs were reduced from 0.55 ± 0.22 to 0.17 ± 0.09. Conclusions: A pharmacist-led PDCA cycle is a feasible and highly effective strategy for fostering the rational use of sodium valproate in neurosurgical settings. These findings highlight the value of multidisciplinary frameworks in enhancing medication safety and institutional resource management within complex clinical environments.
Summary
Keywords
Defined Daily Dose (DDD), Neurosurgery, PDCA cycle (Plan-Do-Check-Act), pharmacist-led intervention, Prescription evaluation, Rational drug use, sodium valproate
Received
13 January 2026
Accepted
18 February 2026
Copyright
© 2026 Li, Ling, Rao, Li, Zhao, Gong, Dai and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Zhuoxue Li
Disclaimer
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