儿童过敏性紫癜药学服务方案的制订及其影响因素分析

Analysis of a pharmaceutical care plan for children with Henoch-Sch?nlein purpura and its influence factors

目的:探讨儿童过敏性紫癜(Henoch-Sch?nlein purpura,HSP)用药教育的需求点及其影响因素,制订针对不同人群的HSP药学服务方案。方法:设计调查问卷,对2016年6―8月在首都医科大学附属北京儿童医院中医科住院治疗的HSP患儿及其家长进行共15个指标的横断面调查,了解不同人群对HSP用药知识的掌握情况,以及其对HSP药学服务的需求点;对主要指标的影响因素进行Logistic回归分析,明确需要分别进行个体化HSP药学服务的人群。结果:被调查的所有家长均认为药师进行出院指导对患儿用药非常有帮助;家长对患儿激素的减量方法和胃肠黏膜保护剂的用法用量知晓率极低;对于大部分指标,来自城市的家长和本科及以上学历的家长较农村家长及高中及以下学历的家长知晓情况好;来自农村的家长和高中及以下学历的家长认为患儿存在家庭服药困难的人数占比大。Logistic回归分析结果显示,被调查患儿家长来源于城市还是农村及受教育程度是部分主要指标的影响因素。结论:应针对城市和农村两类家长人群,制订侧重点不同的个体化药学服务方案,为HSP患儿和家长提供更全面的用药指导,提高院外服药依从性,减少复发。

Objective： To investigate the demands of children with Henoch-SchOnlein purpura （HSP） for pharmaccutical care and the influence factors, and make the HSP pharmaceutical care plan for different patient groups. Methods： A questionnaire was designed to conduct a cross-sectional survey of HSP children and their parents in the traditional Chinese medicine department in our hospital from June to August, 2016. The knowledge about HSP medicines of different groups was understood, as well as the demands for HSP pharmaccutical care. The groups needing individualized pharmaceutical care were identified through Logistic regression analysis of main influence facrs. Results： All of the surveyed people believed that discharge guidarde by pharmacists is helpful for children＇s drug use~ the awareness of glucocorticoids reduction method and the usage and dosage of gastrointestinal protectants was extremely low. For most of the indicators, the parents from cities and having bachelor or higher degrees knew more than the parents from rural areas and who had high school or lower diplomas; more parents from rural areas and having high school or lower diplomas thought their children had difficulties of taking medicines at home. Logistic regression analysis showed that the parents from cities or rural areas and the education level are the influence factors of some main indexes. Conclusion： Individualized pharmaceutical care plans with different emphasis should be made lbr the urban or rural patient groups, taking the 6 major indicators as the core content, and the other 9 secondary indicators as auxiliary content, so as to provide more comprehensive guide for HSP children and their parents, improve the medication compliance outside hospital, and reduce recurrencc, which may have a positive impact on the long-term prognosis of children with HSP.