临床药师参与长期使用糖皮质激素患者药学监护的效果分析

Effect analysis of clinical pharmacists participating in the pharmaceutical care of patients with long-term use of Glucocorticoids

目的探讨临床药师通过药学监护在长期使用糖皮质激素患者治疗中的作用。方法随机选取河源市人民医院2018年7月~2019年12月收治的肾病综合征或系统性红斑狼疮,并长期使用糖皮质激素患者80例。肾病综合征与系统性红斑狼疮以1∶1的方式采用随机数字表法将患者分为观察组(40例)和对照组(40例)。对照组进行常规治疗,不进行临床药学监护,观察组常规治疗同时临床药师参与药学监护,分析两组患者用药依从性,疗效及药物不良反应。结果观察组对疾病及药品认识程度、用药依从性好的患者数均多于对照组,差异有统计学意义(P<0.05)。观察组有更多患者肾功能得到改善,其中尿蛋白减少或转阴的患者多于对照组,差异有统计学意义(P<0.05)。长期服用糖皮质激素患者主要药物不良反应为库欣综合征,发生率高达60%以上,但两组间比较差异无统计学意义(P>0.05);观察组患者失眠不良反应的发生率低于对照组,差异有统计学意义(P<0.05)。结论临床药师参与长期使用糖皮质激素患者的药学监护可提高患者对疾病认识及用药依从性,改善肾功能同时可降低失眠等不良反应的发生。

objective To explore the role of clinical pharmacists in long-term treatment with Glucocorticoids patients through pharmaceutical care.Methods A total of 80 patients with nephrotic syndrome or systemic lupus erythematosus with long-term use of Glucocorticoids in Heyuan People′s Hospital from June 2018 to December 2019 were randomly selected.The patients with nephrotic syndrome and systemic lupus erythematosus in a 1∶1 way were divided into observation group(40 cases)and control group(40 cases)by random number table method.The control group received conventional treatment without clinical pharmaceutical care,and the observation group received conventional treatment with clinical pharmaceutical care,then the compliance,efficacy and adverse drug reactions between two groups were analyzed.Results Compared with the control group,the observation group had more understanding of the diseases,medicines and the drug compliance,the differences were statistically significant(P<0.05).The renal function was improved,and the urinary protein decreased or negative urine patients were more than those in control group,the difference was statistically significant(P<0.05).The main adverse drug reactions were Cushingoid features,with an incidence of more than 60%,but there was no significant difference between two groups(P>0.05).However,the incidence of insomnia adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The clinical pharmacists participated in the pharmaceutical care of patients with long-term use of Glucocorticoids could promote their understanding of the diseases and medicines,drug compliance,improve renal function and reduce the occurrence of adverse reactions such as insomnia.