临床药师参与幽门螺杆菌门诊治疗的药学实践

Pharmaceutical practice of clinical pharmacists participating in outpatient treatment of helicobacter pylori

目的探讨临床药师参与幽门螺杆菌(H.pylori)阳性患者根除治疗的药学实践效果。方法选取2019年8月至12月在北京医院门诊就诊进行首次H.Pylori阳性进行根除治疗患者,根据患者就诊时间分为对照组和观察组。共纳入160例患者,治疗方案均为14 d四联疗法,其中对照组80例在药物应用过程中未进行任何药师干预或咨询,仅医师门诊交代患者;观察组80例患者,药师对患者根除治疗方案进行一对一的用药教育,交代正确的服药方法,指导患者改善生活方式,为患者制定服药记录。两组患者分别于服药结束至少4周以后复查14C尿素呼气试验,检测H.Pylori的根除率,并且接受药师随访,统计患者的依从性,药品不良反应发生率,以及患者对本次就诊治疗的满意程度。结果H.Pylori根除率:观察组92.50%与对照组73.75%比较,P<0.05。经过临床药师的专业指导,与对照组相比,观察组患者正确服药比例(观察组95.00%较对照组77.50%)大幅提高,漏服和中途停药数量减少(P<0.01),两组不良反应的发生率差异无统计学意义。观察组对治疗的满意度(98.75%)高于对照组(78.75%),差异有统计学意义(P<0.05)。结论临床药师参与H.Pylori门诊治疗的药学实践,可以明显提高患者的服药依从性,有利于提高H.Pylori根除治疗的治愈率。

Objective To investigate the pharmaceutical practice effect of clinical pharmacists participating in the eradication treatment of Helicobacter pylori(H.Pylori)positive patients.Methods From August 2019 to December 2019,patients with H.Pylori positive for the first time for eradication treatment in our outpatient department were randomly divided into the control group and the experimental group.A total of 160 patients were included,all of whom were treated with 14-day quadrupled therapy.Among them,80 patients in the control group did not receive any pharmacist intervention or consultation in the course of drug application.In the experimental group of 80 patients,the pharmacist conducted one-to-one medication education on the eradication treatment plan,explained the correct medication method,guided the patients to improve their lifestyle,and made medication records for the patients.Patients in the two groups should reviewed the 14C urea breath test at least 4 weeks after the end of the medication to detect the eradication rate of H.Pylori,and to receive follow-up visits from pharmacists to calculate the patients'compliance,the incidence of adverse drug reactions and the degree of satisfaction of patients with this treatment.Results H.Pylori eradication rate(92.50%in the experimental group vs 73.75%in the control group,P<0.05).After the professional guidance of clinical pharmacists,compared with the control group,the proportion of patients in the experimental group who took the medication correctly(77.50%in the control group vs 95.00%in the experimental group)was greatly increased,and the number of missed doses and drug withdrawals was reduced(P<0.01).There was no statistical difference in the incidence of drug adverse reactions.The treatment satisfaction of the experimental group was higher than that of the control group(experimental group 98.75%vs control group 78.75%),and the difference was statistically significant(P<0.05).Conclusion The participation of clinical pharmacists in the pharmaceutical practice of H.Pylori outpatient treatment can significantly improve the medication compliance and treatment outcome.