冠心病患者全程化药学监护模式的构建

Construction of whole-process pharmaceutical care model for patients with coronary heart disease

目的构建冠心病(CHD)患者全程化药学监护(PC)模式,并分析其应用效果。方法回顾性分析2020年7~9月出院的未进行PC干预的52例CHD患者临床资料,纳入对照组;同时收集2020年10~12月住院的进行全程化PC模式干预的52例CHD患者临床资料,纳入干预组。2组均持续随访12个月,评估患者用药依从性[Morisky用药依从性问卷(MMAS-8)评估]、药物不良反应(ADR)发生率、再次入院率情况。结果采用广义估计方程分析,结果显示,与出院时比较,2组出院6个月、出院12个月时MMAS-8评分均降低,且干预组出院时、出院6个月、出院12个月时MMAS-8评分均高于对照组(P<0.05);随访12个月,干预组ADR发生率低于对照组(P<0.05);2组患者再入院率比较差异无统计学意义(χ^(2)=0.135,P=0.713)。结论全程化PC模式干预可提高CHD患者用药依从性,降低ADR发生率。

Objective To construct the whole-process pharmaceutical care(PC)model for patients with coronary heart disease(CHD)and analyze its application effect.Methods We conducted a retrospective review of CHD inpatients without PC intervention from July to September 2020(n=52,the control group)and CHD inpatients with whole-process PC intervention from October to December 2020(n=52,the intervention group).A followed-up was performed for 12 months,the key observation was the 8-item Morisky Medication Adherence Scale-8(MMAS-8),the adverse drug reactions(ADR),and the readmission rate of patients.Results The results of generalized estimation equation showed that the MMAS-8 scores of both groups were decreased at 6 months and 12 months after discharge compared with those at discharge.The MMAS-8 scores were higher in the intervention group than those in the control group at discharge,6 months and 12 months after discharge(P<0.05).After 12 months of follow-up,the incidence of ADR in the intervention group was lower than that in the control group(P<0.05).There was no statistical significant difference in readmission rate between the two groups(χ^(2)=0.135,P=0.713).Conclusion The whole-process PC mode intervention can improve the medication adherence and reduce ADR incidence for CHD patients.