药物治疗管理模式在医药联合门诊慢性心力衰竭患者中的干预效果

Intervention effect of medication therapy management model in patients with chronic heart failure in combined medical clinic

目的 探究药物治疗管理(MTM)模式在医药联合门诊慢性心力衰竭(CHF)患者中的干预效果。方法 选取2021年1-6月在我院心内科和药学部联合门诊治疗的CHF患者124例,随机分为MTM组和对照组。MTM组由专职临床药师对其进行药物治疗管理干预,而对照组只接受普通药物咨询。在干预后的第3和6个月进行随访,通过比较2组患者在临床疗效、经济成本、人文效果和药物治疗相关问题(DRPs)中的差异评价MTM模式的效果。结果 在接受规范MTM 6个月后,MTM组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)以及射血分数(LVEF)较对照组有显著改善(P <0.05);同时MTM组患者日均药品费用和成本-效用比也明显低于对照组(P <0.05);人文效果评价中欧洲五维健康指数量表(EQ-5D)、Morisky用药依从性量表(MMAS-8)和匹兹堡睡眠质量指数(PSQI),MTM组评分依次为(0.68±0.26)分、(7.52±1.05)分和(7.83±1.09)分;而接受普通药物咨询的对照组,评分依次为(0.69±0.23)分、(6.89±1.15)分和(8.42±1.16)分,MTM组评分明显高于对照组(P <0.05);且MTM组在解决药物相关问题(DRPs)数量上也多于对照组,差异具有统计学意义(P <0.05)。结论 MTM服务模式能显著改善CHF患者的健康状况,使患者在药物治疗效果、经济成本、睡眠质量和药物相关问题上有所获益,值得推广应用。

AIM To explore the intervention effect of medication therapy management(MTM)mode in patients with chronic heart failure(CHF).METHODS From January 2021 to June 2021,124 patients with CHF who were treated in the outpatient department of cardiology and pharmacy in our hospital were selected and randomly divided into MTM group and control group according to their personal wishes.The MTM group was given medication by full-time clinical pharmacists treatment management intervention,while the control group received only general drug counseling.Followup was performed at 3 and 6 months after the intervention.The effect of MTM model was evaluated by comparing the differences in clinical efficacy,economic cost,humanistic effect and drug treatment-related problems(DRPs)between 2 groups.RESULTS After 6 months of standard drug treatment and management,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and ejection fraction(LVEF)of the patients in the MTM group were significantly improved compared with those in the control group(P<0.05).At the same time,the average daily drug cost and cost-utility ratio of patients in the MTM group were also significantly lower than those in the control group(P<0.05).European five-dimensional health index scale(EQ-5D),Morisky medication adherence scale(MMAS-8)and Pittsburgh sleep quality index(PSQI),the scores of the MTM group were(0.68±0.26),(7.52±1.05)and(7.83±1.09)respectively.For the control group receiving general drug counseling,the above scores were(0.69±0.23),(6.89±1.15)and(8.42±1.16)respectively.The scores of the MTM group were significantly higher than those of the control group.There was also a significant difference in the number of drug-related problems(DRPs)solved between 2 groups(P<0.05).CONCLUSION The MTM service model can significantly improve the health status of CHF patients,and benefit the patients in terms of drug treatment effect,economic cost,sleep quality and drug-related issues,which is worthy of popularization and application.