临床药师参与痛风慢病管理的效果评价:一项前瞻性随机对照研究

Evaluation of Effect of Clinical Pharmacists’ Participation in Chronic Disease Management on Gout: A Prospective Randomized Controlled Study

目的通过前瞻性随机对照研究,对临床药师参与痛风慢病管理的效果进行评价。方法将入选的痛风患者随机分为对照组46例和观察组46例,出院后两组接受标准治疗。临床药师对观察组每3个月定期随访,持续1年,根据患者的尿酸达标情况给予用药教育、健康宣教及生活方式干预。结果两组痛风患者的尿酸达标率均呈逐步上升的趋势,治疗依从性则呈下降趋势,随访第6,9,12个月时,观察组尿酸达标率分别为70.83%,78.35%和80.46%,显著高于对照组51.33%,55.78%和53.95%(P<0.05),观察组依从性好的比例分别为91.1%,82.2%和71.1%,显著高于对照组73.9%,60.9%和50.0%(P<0.05);观察组对痛风相关知识的掌握率以及戒酒人数比例均呈逐渐递增的趋势,显著高于同期对照组(P<0.05);观察组和对照组痛风发作人次也都逐渐增多,其中对照组发作频率较观察组明显增快,从第9和12个月分别为17.4%和4.44%,19.6%和4.44%(P<0.05)。结论临床药师参与痛风慢病管理可以提高痛风患者尿酸达标率和用药依从性,改善不良生活习惯,降低痛风发作率,是一种值得临床借鉴推广的痛风防治模式。

Objective To evaluate the effect of clinical pharmacists'participation in chronic disease management on gout through a prospective randomized controlled study.Methods The patients were randomly divided into control group(46 cases)and observation group(46 cases).And the two groups received a standard treatment after discharge.The clinical pharmacists followed up regularly every three-month in one year for the observation group,and the observation group was additionally provided with medication education,health education,and lifestyle intervention according to the patients'uric acid standard.Results In the 6th,9th and12th months of the the follow-up,the recovery rates of uric acid to the standard level in the observation group were 70.83%,78.35%and 80.46%,which were significantly higher than that in the control group(51.33%,55.78%and 53.95%),respectively(P<0.05).The rates of good medication compliance in the observation group were 91.1%,82.2%and 71.1%,which were significantly higher than that in the control group(73.9%,60.9%and 50.0%).The mastery score of gout related knowledge and the proportion of abstaining from alcohol in the observation group were gradually increasing,which were significantly higher than that in the control group at the same time(P<0.05).The numbers of gout attacks in the observation group and the control group were also gradually increased,and the attack frequency in the control group was significantly more than that in the observation group with the rate of 17.4%vs 4.44%and 19.6%vs 4.44%from the 9th and 12th month(P<0.05),respectively.Conclusion The participation of clinical pharmacists in the management of gout could help to improve the recovery rate of uric acid to reach the standard and drug compliance,correct their bad living habits,and reduce the incidence rate of gout.It is a worthy model of clinical recommendation and promotion on the prevention and treatment of gout.