干粉吸入剂药学干预流程的建立及疗效评价分析

Establishment and evaluation of a pharmaceutical intervention procedure for chronic pulmonary disease patients with dry powder inhalers

目的通过建立干粉吸入剂标准用药模式,评价药学干预流程对慢性气道疾病患者应用干粉吸入剂(drypower inhaler,DPI)的疗效影响。方法干预组患者通过药学干预流程及评价规范连续干预6个月,对照组仅常规复诊和随访,评估2组患者治疗前后的DPI装置操作评分、肺功能指标、症状自我评价、吸入药物相关知识掌握及急诊人数。结果慢性阻塞性肺病(COPD)干预组患者经过6个月的药学监护,其吸入装置操作评分、CAT/ACT评分较入组时均改善(t=3. 790、4. 661,P均<0. 05),与对照组比较差异亦有统计学意义(q=3. 108、2. 539,P均<0. 05)。哮喘患者经过6个月的治疗,干预组吸入装置操作评分、FEV1%预计值、ACT评分较入组时均提高(t=4. 622、3. 912、7. 418,P均<0. 05),与对照组比较差异均有统计学意义(q=2. 698、2. 089、2. 264,P均<0. 05)。此外,干预组患者急发就诊人数低于对照组(χ~2=4. 85,P <0. 05),药物相关知识问卷调查得分高于对照组(χ~2=6. 68,P <0. 05),依从性好的人数同样高于对照组(χ~2=8. 15,P <0. 05)。结论建立吸入剂标准用药干预流程,能提高吸入治疗的规范性和有效性,稳定疾病进展,在疾病管理和治疗方面具有较好实践意义和科学价值。

Objective To evaluate the effect of pharmaceutical intervention procedures on the efficacy of dry powder inhalers in patients with chronic pulmonary disease by establishing a standard model.Methods Patients in the intervention group were consecutively intervened for 6 months using the established pharmacological intervention procedure and evaluation criteria.The control group received only routine follow-up.The DPI operating score,lung function index,symptom self-assessment,disease control,drug-related knowledge and number of patients in emergency were evaluated before and after the treatment for the two groups.Results In the intervention group,after 6 months of pharmacological monitoring,the inhalation device operation score and CAT/ACT score of the patients with chronic obstructive pulmonary disease(COPD)were significantly improved compared with the control group(t=3.790,4.661,P<0.05).The difference was also significant compared with the control group(q=3.108,2.539,P<0.05).After 6 months of treatment for asthma patients,the inhalation device operation score,FEV1%predicted value,and ACT score of the intervention group were significantly higher than those of the control group(t=4.622,3.912,7.418,P<0.05).The difference between the two groups was also significant(q=2.698,2.089,2.264,P<0.05).In addition,the number of patients in the intervention group was significantly lower than that that in the control group(χ2=4.85,P<0.05),and the scores of the drug-related knowledge questionnaires were significantly higher than those in the control group(χ2=6.68,P<0.05).The number of people with good adherence was higher than that in the control group(χ2=8.15,P<0.05).Conclusions The establishment of standard medication intervention procedure for inhalants can improve the standardization and effectiveness of inhalation therapy,stabilize disease progression,and have good practical and scientific value in disease management and treatment.