药学监护在高血压患者管控中的作用

Effect of Pharmaceutical Care on Outpatients with Essential Hypertension

目的探讨临床药师开展药学监护对高血压患者用药依从性和血压控制等情况的影响。方法将最终招募到的258名有效病例,随机分为干预组与对照组(各129名),干预组由临床药师给予药学监护,对照组不进行任何干预。分别在随后的9个月内给予每3个月1次的随访,记录药师用药建议、血压达标率和用药依从性等情况。结果两组患者在研究开始前各项指标均无明显差异,在研究结束时,对照组依从性良好,患者从55例(42.6%)增加到71例(55.0%),而干预组从56例(43.4%)增加97(75.2%),两组之间有显著差异;对照组血压达标率从45例(34.9%)提高到65例(50.4%),干预组血压达标率从44例(34.1%)提高到98例(76.0%),组间有显著性差异,在相关常识知晓率方面差异更为显著。研究期间,临床药师共给予干预组患者192条用药建议,对照组未获得解放军302医院临床药师的任何用药建议和药学监护。结论临床药师对高血压患者进行药学监护,能够显著提高患者用药的依从性,有针对性的用药建议能改善高血压患者的达标率。

Objective To evaluate the effect of clinical pharmacists interventions in a prospective randomized controlled trial.Methods Outpatients with essential hypertension were enrolled during a 9-month study with a quarterly follow-up.They were randomly allocated to either intervention group（IG） or control group（CG）.The main data for analysis included the measure of systolic blood pressure and diastolic blood pressure,rate of BP control and medication adherence with a validated questionnaire assessed at the baseline visit and the end of pharmaceutical care.Results There were totally 258 available patients enrolled（129 in CG and 129 in IG） and there was no significant difference between the groups at the baseline.However,the 192 tips to IG patients led to obvious changes in drug therapy,with significant differences in medication adherence,value of blood pressure and rate of blood pressure control compared with CG.Conclusion Clinical pharmacists＇ recommendations can help physicians in the management of hypertensive patients.Pharmacist interventions are effective not only in improving anti-hypertensive medication adherence and health education,but also in achieving blood pressure control.