医联体药师团队参与COPD患者长期用药安全评估管理工作模式的实践研究

Practice and Research of Management Mode of Long-term Medication Safety Assessment for the Patients with Chronic Obstructive Pulmonary Disease by Pharmacist Team in Medical Treatment Alliance

目的:探讨医改新形势下医联体药师团队参与慢性阻塞性肺疾病(COPD)患者长期用药安全评估新型管理模式,为药师参与慢病管理提供参考。方法:选取在我院及医联体所辖5家社区卫生服务中心就诊且符合入选标准的126例COPD患者,由我院临床药师带动指导社区药师共同参与,与医生协作,对患者进行为期1年的安全用药干预管理,包括:用药安全综合评估与分级管理、追踪随访与用药指导,全程化处方审核、建立共享数据库等。结果:该工作模式干预1年后,患者安全用药认知能力及用药依从性较干预前均显著提高(P<0.01),患者COPD疾病控制情况(CAT评分)明显改善(P<0.05或P<0.01),药师有效辨识并干预不合理处方能力显著提升(P<0.01)。结论:医联体药师团队参与COPD患者长期用药安全评估管理工作模式对于保障COPD患者安全用药,提高药物治疗效果,提高药师团队专业服务水平具有显著作用。

Objective： To explore the new management mode of long-term medication safety assessment for chronic obstructive pulmonary disease（ COPD） with the participation of pharmacist team in medical treatment alliance to provide reference for pharmacists participating in the management of chronic diseases under the new situation of new medical reform. Methods： Totally 126 patients with COPD meeting the inclusion criteria in our hospital and medical treatment alliance were selected. The patients received medication management including drug safety comprehensive evaluation,classification management,follow-up with medication guidance,integrated prescriptions checking and shared database building etc with the participation of our clinical pharmacists to guide the community pharmacists in coordination with physicians. Results： After one-year management mode practice,the cognitive ability of safe medication and compliance of the patients significantly increased（ P〈0. 01） with significant improvement of control situation of COPD（ CAT score）（ P〈0. 05 or P〈0. 01）,and the capacity of effective identification and irrational prescription intervention significantly increased（ P〈0. 01）. Conclusion： The management mode of long-term medication safety assessment for COPD patients with the participation of pharmacist team in medical treatment alliance has significant effects on COPD patients＇ safe medication and drug efficacy,which can improve the professional service of pharmacist team.