摘要
目的探讨临床药师主导的药学服务对他汀类药物治疗服务系统构建及评价的影响。方法200例服用他汀类药物治疗的老年(62~88岁)患者,按随机原则分为药师干预组和对照组,每组100例。对照组通过传统用药护理、发放宣教手册、电话回访实施干预;药师干预组在对照组基础上结合药师小组在临床前行讨论模式,经由本社区居委会领导精选交流及协调,每周按时由合格教师或临床药师构建成服务小组,为社区提供免费药学服务和充分培训,进而可更好完成药品使用审评数据分析及收集。对比两组干预前后用药相关问题(DRP)发生情况及药物治疗收益(安全性、有效性、经济性、适当性)。结果干预后,药师干预组DRP发生率30.0%低于对照组的70.0%,差异有统计学意义(P<0.05)。干预后,两组的DRP出现条目数、DRP总药物数量、DRP处方药数量均较干预前减少,且药师干预组减少量更多。干预后,药师干预组药品不良反应(ADR)、重复用药、相互作用、潜在不适当用药(PIM)、其他用药问题发生率分别为13.0%、1.0%、1.0%、2.0%、25.0%,均低于对照组的26.0%、7.0%、7.0%、10.0%、40.0%,差异有统计学意义(P<0.05);药师干预组用药信念好、用药认知好的占比和近3个月就诊率均高于对照组,欧洲视觉模拟标尺法(QOL EQ-VAS)评分低于对照组,医保用药数量、用药数量、月药费均少于对照组,剂量不当、治疗不足的占比均低于对照组,差异有统计学意义(P<0.05)。两组干预后用药依从性好、超适应证、无适应证的占比和欧洲五维健康量表(QOL EQ-5D)评分比较差异均无统计学意义(P>0.05)。结论以临床药师为主导的药学服务,能显著提高老年患者用药安全性、有效性、经济性和适当性,临床药师地位得到提高以及公众的认同。
Objective To discuss the influence of pharmaceutical care provided by clinical pharmacist on the construction of statins treatment service system.Methods A total of 200 elderly patients(62-88 years old)treated with statins were randomly divided into pharmacist intervention group and control group,with 100 cases in each group.The control group was intervened by traditional medication care,distribution of publicity and education manual,telephone return visit;in the pharmacist intervention group,combined with the discussion mode of pharmacist group before clinical,through the selection and communication and coordination of the leaders of the community neighborhood committee,qualified teachers or clinical pharmacists were established into a service group on time every week to provide free pharmaceutical services and sufficient training for the community,so as to better complete the drug use audit data analysis and collection.The occurrence of medication-related problems(DRP)and the benefits of drug treatment(safety,effectiveness,economy,and appropriateness)were compared between the two groups.Results After intervention,the incidence of DRP 30.0%of pharmacist intervention group was lower than 70.0%of the control group,and the difference was statistically significant(P<0.05).After intervention,the number of DRP items,the total number of DRP drugs,the number of DRP prescription drugs of the two groups were less than those before intervention,and the decrease in the pharmacist intervention group was more.After intervention,the incidence of advere drug reactions(ADR),repeated medication,interaction,potentially inappropriate medication(PIM)and other medication problems of pharmacist intervention group were 13.0%,1.0%,1.0%,2.0%and 25.0%,which were all lower than 26.0%,7.0%,7.0%,10.0%and 40.0%of the control group,and the difference was statistically significant(P<0.05).The proportion of good medication beliefs and good medication awareness and medical visit rate in the recent 3 months of pharmacist intervention group were all higher than those of the control group,Euro QOL visual analogue scale(QOL EQ-VAS)score was lower than the control group,medical insurance medication quantity,medication quantity and monthly medication fee were less than those of the control group,and improper dosage and inadequate treatment were lower than those of the control group.All the difference was statistically significant(P<0.05).After intervention,there was no statistically significant difference in proportion of good medication compliance,out-of-indications,no indications and European 5-dimensional health scale(QOL EQ-5D)score between the two groups(P>0.05).Conclusion The pharmaceutical care led by clinical pharmacists can significantly improve the safety,effectiveness,economy and appropriateness of medication for elderly patients,and the status of clinical pharmacists can be improved and recognized by the public.
作者
王庆月
杜书君
WANG Qing-yue;DU Shu-jun(Yanggu County People’s Hospital,Liaocheng 252300,China)
出处
《中国现代药物应用》
2021年第7期235-238,共4页
Chinese Journal of Modern Drug Application
关键词
临床药师
药学服务
他汀类药物
治疗服务系统
构建
评价
Clinical pharmacist
Pharmaceutical care
Statins
Treatment service system
Construction
Evaluation
