药学服务干预儿童慢性咳嗽的效果分析

Effect Analysis of Pharmaceutical Care Intervention on Children with Chronic Cough

目的：通过对儿童慢性咳嗽患者和其家属的药学服务,提高该病的治疗效果,促进合理用药。方法：收集2013年下半年门诊儿童慢性咳嗽前3位病因,分别是咳嗽变异性哮喘（69例）、上气道咳嗽综合征（62例）、感染后咳嗽（51例）,共182例患儿,年龄为0~14岁,随机分为试验组和对照组,试验组给予全程药学服务干预,包括设计和填写问卷调查表、用药前教育、建立药历、反馈医生、门诊咨询和电话随访等,对照组采用传统的治疗模式,分别对两组患儿的药物使用情况、疾病发作就诊的门诊及急诊次数、治疗药费支出进行观察分析。结果：咳嗽变异性哮喘引起的咳嗽患者在接受药学服务干预3个月后,口服抗菌药物使用率降至0.00%,与对照组21.74%相比,差异有统计学意义（P〈0.05）;而在吸入糖皮质激素的使用上,试验组使用率达到100.00%,高于对照组30.43%,差异有统计学意义（P〈0.05）。上气道咳嗽综合征引起的咳嗽患者在接受药学服务干预后,口服抗菌药物使用率降至0.00%,与对照组26.83%相比,差异有统计学意义（P〈0.05）;而在吸入糖皮质激素使用上,试验组1个月和3个月使用率分别增加至38.10%和47.62%,与对照组12.2%和9.76%相比,差异有统计学意义（P〈0.05）。感染后咳嗽患者接受药学服务干预3个月后,口服抗菌药物使用率降至0.00%,与对照组31.25%相比,差异有统计学意义（P〈0.05）;而吸入糖皮质激素使用率1个月后增加至47.37%,与对照组9.38%相比,差异有统计学意义（P〈0.05）。所有药学服务组患儿1个月和3个月随访的门诊次数及药费累计支出均低于对照组,差异有统计学意义（P〈0.05）。结论：对儿童慢性咳嗽患者及家属给予全程药学服务干预,能够提高治疗效果、促进合理用药以及减少药费支出。

Objective：Through providing pharmaceutical care to the children with chronic cough and their families to improve the therapeutic effects of chronic cough and promote rational use of drugs.Methods：A total of182 children aged 0 ~ 14 years old,who were diagnosed as chronic cough in our hospital during the second half of 2013,were divided into cough variant asthma（CVA）,upper airway cough syndrome（UACS） and post infection cough（PIC） groups by the causes of cough and number of patients in each group was 69,62 and 51 respectively.Each group was randomly divided into experimental group and control group.The experimental groups received not only conventional treatment but also pharmaceutical care intervention,including questionnaire design and fulfillment,education before treatment,the establishment of drug record,feedback to the doctors,outpatient counseling and telephone follow-up for patients.The control groups only received conventional treatment.Investigation and analysis of the experimental and control groups were made on the medication use,times of outpatient and emergency visits upon outbreak of disease and the total medication expenses.Results：In CVA group,oral antibiotics consumption rate decreased to 0.00% after three month intervention by pharmaceutical care,which was significantly lower than that in control group（21.74%） with the statistical significance of P 0.05.The utilization of inhaled corticosteroids in experimental group was 100.00% through the period of pharmaceutical care,which was higher than that in control group（30.43%）（P 0.05）.In UACS group,the utilization rate of oral antibiotics in intervention group decreased to 0.00%,which was much lower than that in control group（26.83%）（ P 0.05）.The utilization rates of inhaled corticosteroids in experimental group increased to 38.10% and 47.62%after one and three month interventions of pharmaceutical care,while there were only 12.2% and 9.76% in control group（P 0.05）.In PIC group,the usage rate of oral antibiotics decreased to 0.00% after three month intervention of pharmaceutical care and 31.25% in control group（P 0.05）.The utilization rate of inhaled corticosteroids in experimental group increased to 47.37% after one month of the drug administration and which was 9.38% in control group（P 0.05）.In all three experimental groups,the frequency of outpatient visits and the total medication expenses were much lower than those in control groups,and there was a statistical significance between the experimental and control groups（P 0.05）.Conclusion：The whole course of pharmaceutical care intervention to the children with chronic cough and their families can improve the therapeutic effect,promote rational drug use and decrease the medication expenses.