临床药师参与老年患者综合评估及其用药管理工作模式的实践与体会

Practice and Experience of Clinical Pharmacists Participating in Comprehensive Evaluation of Elderly Patients and Medication Mode

目的:探究临床药师参与老年患者综合评估及其用药管理的效果及其体会。方法:选取2017年2月—2018年1月期间收治的34例采用一般综合评估模型的多重用药老年患者资料为干预前组,另抽取2018年2月—2019年1月期间收治的34例采用临床药师参与综合评估及用药管理模型的多重用药老年患者资料为干预后组;比较两组患者治疗前后日常生活能力Barthel指数、认知、跌倒风险的评分值变化情况,以及治疗前后用药疗效、不良反应发生率和合理的药物治疗率的差异。结果:干预后组患者用药依从率显著高于干预前组(P<0.05),用药疗效和用药的合理率显著高于干预前组(P<0.05),不良反应发生率低于干预前组(P<0.05);干预后组患者Barthel指数、认知的评分值显著高于干预前组(P<0.05),跌倒风险的评分值显著低于干预前组(P<0.05)。结论:临床药师参与老年综合评估及用药管理,显著地提高了患者用药的合理性和用药的依从性,确保了药物治疗的有效性和安全性。

Objective:To explore the effectiveness and experience of clinical pharmacists participating in the comprehensive evaluation and medication management for elderly patients.Methods:The data of 34 elderly patients with multiple drugs admitted from February 2017 to January 2018 using the general comprehensive assessment model were selected as the pre-intervention group,and the data of 34 elderly patients with multiple drugs admitted from February2018 to January 2019 using the clinical pharmacist participating in the comprehensive assessment and medication management mode were selected as the post-intervention group.The changes in Barthel index of daily living ability,cognition,and fall risk scores before and after treatment were compared between the two groups,as well as the differences in drug efficacy,adverse reaction rate and reasonable drug treatment rate before and after treatment.Results:After intervention,the compliance rate of patients in the group was significantly higher than those in the group before intervention(P<0.05),the efficacy and rationality rate of medication were significantly higher than that in the group before intervention(P<0.05),and the incidence of adverse reactions was lower than that in the group before intervention(P<0.05).The scores of Barthel index and cognition of patients in the post-intervention group were significantly higher than those in the pre-intervention group(P<0.05),and the scores of fall risk were significantly lower than those in the pre-intervention group(P<0.05).Conclusion:The participation of clinical pharmacists in geriatric comprehensive assessment and medication management significantly improved the rationality and compliance of medication,and ensured the effectiveness and safety of medication.