某院风湿免疫科以药师为主导的患者慢性疾病药物治疗管理模式的建立与实践

Establishment and practice of medication therapy management model with pharmacists as the leader for patients with chronic diseases in rheumatic immunology department

目的:探讨药师为风湿免疫疾病患者提供慢性疾病药物治疗管理(medication therapy management,MTM)的模式。方法:以某院风湿免疫科中类风湿性关节炎、系统性红斑狼疮及强直性脊柱炎患者为研究对象,收集患者200例,随机分成药学干预组和对照组,对药学干预组实施MTM。将2组患者入院初期、出院后1个月、出院后3个月、出院后6个月的临床评价指标、患者依从性评分、药学干预期内再入院率和不良反应发生率进行2组间的比较,观察MTM的实施效果。结果:与对照组相比,临床疗效指标在出院后3个月、6个月有更好的改善,差异具有显著性(P<0.05);患者依从性在出院后3个月、6个月有较高的评分,差异具有显著性(P<0.05);药学干预组的再入院发生事件略有下降,但差异无显著性;出院后6个月药学干预组ADR发生率明显低于对照组,差异具有显著性(P<0.05)。结论:通过对风湿免疫患者实施MTM,可以达到提高药学服务质量和临床疗效的目的。

OBJECTIVETo discuss the mode of medication therapy management(MTM)with rheumatism immune diseases.METHODS The study objects were rheumatism immunity patients with rheumatoid arthritis,systemic lupus erythematosus andankylosing spondylitis in our hospital.Two hundred patients were divided into pharmaceutical intervention group and controlgroup.Patients in pharmaceutical intervention group were given MTM.Clinical evaluation indicators,medication compliance,re-admission rate and incidence of adverse drug reactions(ADR)were expected to make the comparison between the two groupsat initial period of admission and 1,3,6 months after intervention,to observe the implementation effects of MTM.RESULTSCompared with control group,the clinical efficacy indexes were improved better after discharge from hospital 3 and 6 monthslater(P<0.05).Medical compliance had higher scores 3 and 6 months after discharge(P<0.05).The incidences of re-admis-sion in the pharmaceutical intervention group decreased slightly,but there was no statistical significance.The incidence of ADRin pharmaceutical intervention group was significantly lower than that of control group 6 months after discharge from hospital(P<0.05).CONCLUSIONBy applying MTM to rheumatism immune patients,the quality of pharmaceutical services and clinical efficacy can be improved.