全程化药学服务干预社区慢性阻塞性肺疾病患者病情分析

Effects of Integrated Pharmaceutical Care on Patients with Chronic Obstructive Pulmonary Disease in Community

目的采用全程化药学服务对社区慢性阻塞性肺疾病(chromic obstructive pulmonary disease,COPD)患者进行干预,倡导合理用药、改善病情、提高生存质量。方法将社区确诊为COPD的150例患者随机分为干预组(A组)79例,对照组(B组)71例,A组采用全程化药学干预方法。B组不施行干预措施。结果干预后显示A组呼吸专科药理知识成绩显著提高,B组干预前后无明显变化;药物治疗作用和副作用总知晓率A组高于B组;A组症状、体征、6分钟行走距离(6MWD)、膈肌移动度(DM)、常规肺功能部分指标等较B组改善明显(P<0.05);生存质量(QOL)调查提示A组QOL总分、总均分、生活能力、社会交往等评估优于B组,差异均有统计学意义(t=2.624、P=0.010,t=2.633、P=0.009,t=5.960、P=0.000,t=3.785、P=0.000);A组年就诊数、年住院率和年治疗费用支出分别降低,与B组相比差异均有统计学意义(P<0.05),成本-效果分析表明A组优于B组。结论社区全程化药学服务可改善COPD患者病情和提高生存质量。

Objective To analysis the effect of integrated pharmaceutical care interferences on patients with chronic obstructive pulmonary disease（COPD） in community. Methods One hundred and fifty patients with COPD in community were divided into in- terference group（group A,79 cases） and contrast group（group B,71 cases）. Group A received the integrated pharmaceutical care interferences. Results The pharmaceutical knowledge about respiratory diseases after the interference was obviously improved in group A （P 〈 0.05 ）, but not in group B. The total awareness rate of therapeutic and adverse effects of drugs was higher in group A than that in group B. The improvement of symptoms,signs,6 minutes walk distance（6MWD） ,diaphragm movement（DM） and pulmonary function（ VC ,FEV1 ） was obvious in group A as compared to group B （P 〈 0.05 ）. The evaluation of QOL showed that the improvement was remarkable in total score （ t = 2.624,P = 0. 010 ）, average score （ t = 2. 633, P = 0. 009 ）, ability of life （ t = 5. 960, P = 0. 000） and social activity score （t = 3. 785, P = 0. 000）. The visiting rate . annual hospitalization rate and therapeutics cost were decreased in group A, and the difference between the two groups has statistical significance. Conclusion The integrated pharma- ceutical care can improve the state and QOL of patients with COPD in community.