药师主导的药学服务对社区高血压病人疗效的影响

The influence of pharmaceutical care dominated by pharmacists on medication of community patients with hypertension

目的:评价药学服务团队对社区高血压病人药物治疗的干预效果。方法:对社区高血压病人进行高血压病的相关知识、合理用药和保健知识教育,结合随访、用药指导等干预措施,以病人血压水平、对高血压知识的认知程度和用药依从性为指标,评价干预效果。结果:干预1年后,病人血压达标率从27.59%提高到93.10%,收缩压和舒张压平均下降14.26、9.01mm Hg;用药种类和金额略有下降;病人对高血压知识的答卷分数从干预前的63.41分提高到97.27分;用药依从性显著提高;部分血液生化指标超标率下降,身体质量指数(BMI)下降(P<0.05)。干预结束后的第5、第14个月,病人血压达标率分别为89.66%和81.48%,用药依从性有所下降,但仍能维持在较高水平。结论:资深药师主导的药学服务团队实施以高血压及其药物治疗相关知识教育、随访和用药指导为核心的综合干预措施,有助于大幅提高病人的药物治疗知识水平,增强居民合理用药意识,提高病人的用药依从性、血压达标率和生活质量,而持续的干预对于长期维持血压达标率是必需的。

Objective： To evaluate the intervention effects of pharmaceutical care team dominated by pharmacists on medication of community patients with hypertension. Methods：The education about the knowledge of hypertension and rational drug use was carried out. Life and health care on the patients was performed combining with intervention measures such as continuous follow-up and medication guidance. Then the intervention effects were investigated by measuring the levels of blood pressure,the hypertension-related knowledge and the medication compliance of patients. Results： At the end of one-year intervention course, qualified rates of blood pressure increased from 27.59% before intervention to 93.10 %, and the average decrea- ses of systolic and diastolic pressures were 14.26 and 9.01 mm Hg,respectively. The variaties and the costs of drugs slightly decreased. The average score of the questionnaire about hypertension-related knowledge increased from 63.41 to 97.27. The medication compliance improved significantly. The unqualified rates of some biochemical indexes were decreased, and the body mass indexes （BMI） of the patients were decreased significantly（P〈0.05）. The qualified rates of blood pressure at the 5th and 14th months after the intervention end were 89. 66% and 81. 48%, respectively, and the medication compliance among the patients declined, but still maintained at high level. Conclusion：The comprehensive intervention measures adopted by the pharmaceutical care team and dominated by senior pharmacists such as the education about the knowledge of hypertension and rational drug use,together with continuous follow-up and medication guidance on community patients with hypertension may substantially raise the patients＇ medicine knowledge level, enhance the awareness of rational drug use, and improve their medication compliance,blood pressure qualified rate and life quality. Thus continuous intervention is necessary to maintain persistent blood pressure qualified rate.