教育管理对慢性心力衰竭患者使用β受体阻滞剂依从性的影响

Influence of medication education management on compliance for administration of β receptor blocker in patients of chronic heart failure

目的 对比研究教育管理对慢性心力衰竭患者使用β受体阻滞剂依从性及远期预后的影响.方法 连续纳入2011年1月至2012年1月在北京安贞医院住院的慢性心力衰竭患者330例,按随机数字表法分成教育管理组（165例）与常规治疗组（165例）.教育管理组对患者进行健康知识宣教及定期随访,常规治疗组以传统诊疗形式进行管理.随访1年,比较2组患者β受体阻滞剂使用率及因心力衰竭再住院率.结果 入组时教育管理组与常规治疗组患者的β受体阻滞剂使用情况差异无统计学意义[44.2％ （73/165）比46.7％ （77/165）,P＞0.05）].1年后,教育管理组患者β受体阻滞剂使用率明显高于常规治疗组[58.1％（96/165）比31.5％ （52/165）],自行停药率明显低于常规治疗组[87.5％（56/165）比96.6％ （114/165）],因心力衰竭再住院率明显低于常规治疗组[9.1％（15/165）比17.6％ （29/165）],差异均有统计学意义（均P ＜0.05）.教育管理组心源性死亡发生率与常规治疗组比较,差异无统计学意义[1.8％ （3/165）比2.4％（4/165）,P＞0.05].结论 对慢性心力衰竭患者进行教育管理可以提高β受体阻滞剂使用依从性,并降低患者的心力衰竭再住院率.

Objective To explore the influence of medication education management on the compli- ance for administration of [3 receptor blocker in patients of chronic heart failure. Methods Totally 330 pa- tients discharged from Beijing Anzhen Hospital hospital from January 2011 to January 2012 were continuously enrolled and were randomly divided into education group （ 165 cases） and conventional visit group（ 165 ca- ses）. The patients in education group received heart failure education and regular follow-up, the patients in conventional visit group received conventional outpatient visit. After one year, the rate of 13 receptor blocker, taken heart failure readmission and mortality of cardiogenic death were compared between the two groups. Results The [3 receptor blocker taken rate of the two groups at baseline had no statistical difference[44.2% （73/ 165 ）vs 46.7% （77/165）, P 〉 0.05 ]. After 1 year follow-up, education group showed a significant raise of the com- pliance for 13 receptor blocker taken compared with conventional visit group [ 58.1% （96/165） vs 31.5% （53/ 165）, P 〈0.05] and the rate of drug withdrawal was also significantly declined compared with conventional visit group I87.5% （56/165） vs 96.6% （114/165）, P 〈0.05]. The readmission for heart failure in education group was statistical lower than that in conventional visit group [9.1% （15/165） vs 17.6% （29/165）, P 〈0.05], while the mortality of cardiogenic death showed no statistical significance between the two groups [ 1.8% （ 3/165 ） vs 2.4% （4/165）, P 〉0.05 ]. Conclusion The compliance for administration of β receptor blocker in patients of chronic heart failure can be enhanced through educating the patients by doctors, and the readmission rate for the heart failure can be also decreased.