带状疱疹患者药学监护路径的建立及效果

Establishment of Pharmaceutical Care Pathway on Herpes Zoster and its Effect

目的:建立与带状疱疹临床路径相匹配的药学监护路径,规范带状疱疹药物治疗过程。方法:随机选取2012-2018年山东省千佛山医院只接受临床路径管理的100例带状疱疹患者作为对照组;随机选取同期100例带状疱疹患者作为观察组,由临床路径和药学监护路径共同管理,临床药师全程参与观察组患者的临床治疗,提供全程药学服务与用药指导。比较两组患者药品不良反应发生率、用药依从性、住院费用、药品费用、药占比、治疗药物、用法与用量、住院时间及患者满意度等指标的差异。结果:观察组患者的不良反应发生率明显低于对照组(P=0.03),用药依从性明显高于对照组(P=0.027),患者满意度明显高于对照组(P=0.017),平均住院时间明显短于对照组(P<0.001),住院药品费用明显低于对照组(P<0.001),药占比明显低于对照组(P<0.001),上述差异均有统计学意义;观察组的住院总费用低于对照组,但差异无统计学意义(P=0.158)。结论:专业、规范的药学服务路径可提高患者的用药安全性与有效性,提高医疗质量和患者满意度,可成为临床路径的有益和必要的补充。

OBJECTIVE: To establish pharmaceutical care pathway that matched with the clinical pathway of herpes zoster, so as to standardize the treatment of herpes zoster. METHODS: 100 patients with herpes zoster which received clinical pathway in Qianfoshan Hospital of Shandong Province during 2012-2018 were selected as control group;another 100 patients with herpes zoster were selected as observation group at the same term, which were management by clinical pathway and pharmaceutical care pathway, clinical pharmacists participated in the treatment process of the observation group, providing full-course pharmacy services and medication guidance. Differences in incidences of adverse drug reactions, compliance, hospitalization expenses, drug expenses, the percentage of drug cost, applied drugs, usage and dosage, hospital stays and satisfaction degree of patients between two groups were compared. RESULTS: The incidence of adverse drug reactions(P=0.03), compliance(P=0.027) and satisfaction degree(P=0.017) of observation group was significantly lower than that of the control group, with significantly shorter hospital stay(P<0.001), lower drug expense(P<0.001) and lower percentage of drug cost(P<0.001) than those of the control group. The hospitalization expense of observation group was lower than that of the control group, while the difference had no statistical significance(P=0.158). CONCLUSIONS: Professional and standardized pharmaceutical service pathway can improve the safety and effectiveness of patients’ medication, improve medical quality and satisfaction degree, which can be a useful and necessary supplement for its clinical pathway.