基于护士主导的微信平台改善克罗恩病病人硫唑嘌呤服药依从性的研究

Efficacy of a nurse-led WeChat follow-up program on adherence to azathioprine in Crohn’s disease patients:a randomized controlled trial

[目的]构建基于护士主导的克罗恩病病人药物管理微信平台,并探讨其对克罗恩病病人硫唑嘌呤服药依从性的影响。[方法]选取2016年5月—2018年4月东部战区总医院炎症性肠病中心的克罗恩病病人239例随机分为微信组(120例)和对照组(119例),对照组接受胃肠医师常规的门诊及电话随访指导,微信组接受基于护士主导的微信平台构建的克罗恩病病人药物管理方案。[结果]干预第1个月、第2个月两组病人依从性得分差异无统计学意义;第4个月开始,微信组依从性得分高于对照组(P<0.05),断药率低于对照组(P<0.05);两组硫唑嘌呤血药浓度及粪便钙卫蛋白水平比较差异有统计学意义(P<0.05);两组累积药物不良事件发生率、医疗费用无明显差异(P>0.05)。[结论]实施基于护士主导的微信平台构建的克罗恩病病人药物管理方案可使病人主动参与疾病管理,一定程度上可改善病人的服药依从性。

Objective:To construct a nurse-led wechat follow‐up program of drug management for Crohn's disease(CD)patients,and to explore its effect on azathioprine compliance of CD patients.Methods:From May 2016 to April 2018,239 patients with CD in the General Hospital of the Eastern Theater were randomly divided into WeChat group(120 cases)and control group(119 cases).The control group received physician's routine outpatient and telephone follow‐up guidance,The WeChat group received nurse-led WeChat follow‐up program of drug management.Results:There was no significant difference in compliance scores between the first and second months.At the forth month,the compliance score of the WeChat group was higher than that of control group(P<0.05).And the drug withdrawl rate in the WeChat group was lower those in control group(P<0.05).The difference in the plasma concentration of azathioprine and the level of fecal calprotectin between two groups were significant(P<0.05);There were no significant difference in the occurrence of adverse drug events and medical expenses.Conclusion:The nurse‐led WeChat follow‐up program of drug management could enable patients to actively participate in disease management,and improve medication compliance.