用药指导对缺血性脑卒中二级预防用药依从性和危险因素控制的影响

Effect of Medication Guidance on the Compliance of Secondary Prevention Medication and Risk Factors Control in Patients with Ischemic Stroke

目的探讨用药指导对缺血性脑卒中二级预防用药依从性和危险因素控制的影响。方法选取医院神经内科2015年1月至2017年12月收治的缺血性脑卒中患者203例,除去随访时脱落病例,共纳入188例,随机分为对照组(92例)和观察组(96例)。两组患者出院时均进行常规二级预防用药指导,观察组在此基础上,由临床药师对出院带药及服用方法进行纸质材料+口头讲解的用药教育,随访6个月。结果出院后6个月,观察组患者继续服用抗栓药、调脂药、降压药、降糖药,坚持血压、血糖监测及血压、血糖达标人数均显著多于对照组(P<0.05),漏服或重复用药、随意增减剂量、随意停药、随意更换药品及脑卒中再发人数均显著少于对照组(P<0.05)。结论用药指导可显著提升缺血性脑卒中患者二级预防治疗服药依从性,降低血压、血脂、血糖及相关不良事件等危险因素的发生率,有助于预后。

Objective To investigate the effect of medication guidance on the compliance of secondary prevention medication and risk factors control in patients with ischemic stroke.Methods Totally 203 patients with ischemic stroke admitted to the Department of Neurology of our hospital from January 2015 to December 2017 were selected.Excluding the shedding cases during the follow-up,188 patients were included and randomly divided into the control group(n=92)and the observation group(n=96).All patients were given routine secondary prevention medication guidance for ischemic stroke when discharged from our hospital.On this basis,the patients in the observation group were educated by clinical pharmacists on the discharge medication and taking methods with paper material and oral explanation.Results Six months after discharge,the patients who continued to take antithrombotic drugs,lipid-lowering drugs,hypotensive drugs and hypoglycemic drugs,those who insisted on monitoring blood pressure and blood glucose and those whose blood pressure and blood glucose met standards in the observation group were significantly more than those in the control group(P<0.05),the patients who skipped or re-administered medication,randomly increased or decreased dosage,randomly drug withdrawal,randomly changed medicines and the recurrence of stroke in the observation group were significantly fewer than those in the control group(P<0.05).Conclusion Medication guidance can significantly improve the compliance of secondary prevention and treatment medication in patients with ischemic stroke,reduce the incidence of risk factors such as blood pressure,blood lipid,blood sugar and related adverse events,which is helpful to the prognosis.