阿司匹林用药依从性的干预研究

Intervention study on compliance of aspirin in clinical practice

目的:对于使用阿司匹林预防心血管疾病的患者,通过临床药师宣传、讲解阿司匹林用药知识,了解临床药师对阿司匹林依从性的影响。方法:选择使用阿司匹林预防心血管疾病的患者262例。临床药师宣传讲解阿司匹林预防心血管疾病的疗效、用药剂量、服用时间与疗程、不良反应鉴别及减少、减轻药品不良反应的措施。宣教干预前后,给每位患者分别进行B超检查,并测定出凝血时间、血常规、肝功能、肾功能。结果:患者对阿司匹林用药预防心血管疾病的信心显著增强,患者全部相信临床药师的用药讲课。讲解干预后依从性四个检验项目(按次数服用、按剂量服药、按时服用、坚持长期用药)评分均优于干预前。胃肠道反应、出血倾向、血栓形成、肝功能异常四项指标干预后显著降低,但肾功能异常、神经系统症状及凝血障碍降低无统计意义。干预后依从性(68.3%)较干预前(23.3%)有显著提高。结论:临床药师通过讲课等形式积极干预,可以显著提高阿司匹林用药依从性。

AIM：To examine the effect of clinical pharmacists＇ intervention on compliance of aspirin.METHODS：262 cardiovascular patients with hypertension,diabetes,coronary heart disease,stroke or hyperlipemia were randomly chosen.Clinical pharmacists gave the patients four lessons about aspirin,such as the effect of aspirin to prevent and cure cardiovascular diseases,the canonical dosage,usage and course,the skill how to reduce adverse reactions of aspirin et.Blooding time,clotting time,routine blood test,liver function and kidney function were examined before and after the intervention.RESULTS：After four lessons about aspirin given,all the patients gained more confidence in aspirin to prevent cardiovascular disease.IPSs of the four measurement indicators of the compliance （the number,the dosage,the time,and long-term medication by doctors） were excellent than before the lessons.The occurrence rates of gastrointestinal reactions,bleeding tendency,thrombophilia,abnormal liver function were reduced significantly,the rates of abnormal kidney function,nervous system reactions and coagulopathy were reduced too.The compliance after intervention （68.3%） was higher than the compliance before intervention （23.3%） dramatically and the difference was statistically significant（P〈0.05）.CONCLUSION：Clinical pharmacists can improve medication compliance of aspirin by active intervention such as give lessons.