慢性阻塞性肺疾病患者全程化药学服务模式的建立与效果评价

Establishment and Evaluation of Integrated Pharmaceutical Care on COPD Patients

目的:建立慢性阻塞性肺疾病(COPD)住院患者全程化药学服务模式,考察其对患者用药安全性和有效性的影响。方法:采用随机、对照、前瞻性试验方法,将COPD住院患者随机分至试验组和对照组中。对照组患者接受传统的住院医疗服务项目,试验组患者在此基础上实施全程化药学服务。考察两组患者入院时和出院1个月随访时的用药依从性,患者满意度、用药偏差、药品不良事件(ADE)发生率和12个月后的非预约再入院率。结果:试验组出院1个月随访时的用药依从性较本组入院时明显提高(P<0.01),且显著高于同时期的对照组(P<0.01)。试验组对医疗过程及用药指导的满意度均显著高于对照组(P<0.01),1年后非预约入院1次的比例和总的用药偏差发生率均明显低于对照组(P<0.01)。试验组发生的ADE(2例)少于对照组(9例),但差异无统计学意义(P>0.05)。结论:临床药师对患者进行全程化药学服务可显著改善患者的用药依从性和满意度、减少非预约再入院率、降低用药偏差,保证患者用药的安全性和有效性。

Objective：To establish an integrated Pharmaceutical care model and investigate the influence of inte- grated Pharmaceutical care in patients with drug safety and efficacy. Methods：We designed a randomized, controlled, prospective trial, COPD patients were randomly assigned to experimental group and the control group. Patients in the control group received traditional inpatient medical services, while patients in the experimental group performed integrated Pharma- ceutical care on this basis. We evaluate hospitalized medication compliance, patient satisfaction, medication errors adverse drug events （ADE） incidence at the time of admission and at 1-month discharge from hospital, and non-appointment admis- sion at 12-month discharge from hospital. Results ：The medication compliance of the experimental group at the 1-month fol- low-up was significantly higher than that at the time of admission （ P 〈 0.01 ）, and was significantly higher than that of the control group at the 1-month follow-up （P 〈0.01 ）. Compared with the control group, patient satisfaction with the general medical procedure and the medication care process were both significantly increased （P 〈 0.01 ） , the rate of 1-year non-appointment admission significantly reduced （P 〈0.01 ） and medication errors significantly reduced （P 〈 0.01 ）, preventable adverse drug events in the experimental group （two cases） was significantly less than the control group （9 cases）, but the difference was not statistically significant （P 〉 0.05 ）. Conclusion ：The results showed that integrated Pharmaceutical care could significantly improve patient medication compliance and satisfaction, reduce non-appointment admission and medica- tion errors, then we could ensure the safety and efficacy of patient medication.