临床药学路径对AECOPD患者治疗的干预效果

Intervention effect of clinical pharmacy pathway on the treatment of AECOPD patients

目的观察临床药学路径对慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗的干预效果,为规范临床用药、医保控费,减轻患者负担提供参考。方法选取2017年7月-2018年7月银川市第一人民医院呼吸与危重症科第一诊断为AECOPD住院患者300例为研究对象,采取随机数字表法分为观察组和对照组,每组150例。对照组给予常规药学指导,观察组实施临床药学路径方案,比较2组治疗后住院时间、住院费用、药品费用、抗菌药物使用强度(DDDs)、用药偏差发生率、患者满意度指标、用药依从性的变化情况。结果观察组住院时间短于对照组,平均住院费、药品费用均低于对照组(P <0.01);观察组DDDs、抗菌药物联合使用率均低于对照组(P <0.01);观察组用药偏差发生率低于对照组,患者满意度高于对照组(P <0.01);观察组用药依从率为94.74%,高于对照组的84.37%(χ2=5.469,P=0.012)。结论临床药师通过开展临床药学路径,可有效缩短AECOPD患者住院时间及降低医疗费用、药品费用,促进抗菌药物的合理使用,提高住院患者用药依从性及满意度,并减少用药偏差发生率,有助于医保控费,减轻患者经济负担。

Objective Observe the intervention effect of clinical pharmacy pathways on the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),provide references for standardizing clinical medication,medical insurance cost control,and reducing the burden on patients. Methods From July 2017 to July 2018,300 patients with AECOPD who were first diagnosed as AECOPD in the department of respiratory and critical care of Yinchuan First People’s Hospital were selected as the research objects,and were randomly divided into observation group and control group with 150 cases in each group. The control group was given conventional pharmacy guidance,and the observation group implemented the clinical pharmacy route plan,compare the hospitalization time,hospitalization expenses,drug costs,defined daily doses(DDDs),incidence of medication deviation,patient satisfaction index and medication compliance between the two groups. Results The hospitalization time in the observation group was shorter than that in the control group,and the average hospitalization and drug costs were lower than those in the control group(P < 0. 01). The DDDs and the combined use rate of antibiotics in the observation group was lower than that in the control group(P < 0. 01). The incidence of medication deviation in the observation group was lower than that of the control group,and patient satisfaction was higher than that of the control group(P < 0. 01). The medication compliance rate of the observation group was 94. 74%,which was higher than 84. 37% of the control group(χ~2= 5. 469,P = 0. 012). Conclusion Through the development of clinical pharmacy pathways,clinical pharmacists can effectively shorten thehospitalization time of AECOPD patients,reduce medical and drug costs,promote the rational use of antibacterial drugs,improve the compliance and satisfaction of inpatients with medication,and reduce the incidence of medication deviation,which help medical insurance cost control and reduce the financial burden of patients.