基于多学科协作门诊抑郁障碍全程药物治疗管理效果研究

Study on the Effect of Whole-course Medication Therapy Management for Depression in Outpatient Clinics based on Multidisciplinary Cooperation

目的探讨构建基于多学科协作的抑郁障碍全程药物治理管理模式及在实践过程中的应用效果。方法建立由医师、药师和心理咨询师组成的治疗协作团队,由药师主导实施全程药物治疗管理(MTM)工作。选取江门市某精神专科医院门诊治疗的抑郁障碍患者120例,随机分为对照组和实验组,每组60例。对照组予常规诊疗和发药窗口用药指导,实验组患者进入抑郁障碍多学科协作组,予全程MTM干预。干预6个月后对比两组患者服药依从性、药物不良反应(ADR)、再入院率3个方面差异。结果与对照组比较,经干预后实验组患者的各级依从程度人数变化具显著统计学差异(P<0.01),ADR评分降低(P<0.05)。再入院率降低,但差异无统计学意义(P>0.05)。结论实施基于多学科协作抑郁障碍全程药物治理管理模式能提高患者服药依从性,改善药物不良反应,具有一定的成效。

OBJECTIVE To explore the construction of the whole course medication therapy management model of depression based on multidisciplinary collaboration and its application effect in practice. METHODS The therapeutic collaboration team composed of physicians, pharmacists and psychological consultants were established, and the implementation of the entire medication therapy management(MTM) work was leaded by pharmacist. A total of 120 depressed patients treated in the outpatient department of a psychiatric hospital in Jiangmen City were selected and randomly divided into the control group and the experimental group with 60 cases in each group. The control group was given routine treatment and medication guidance at the drug delivery window. Patients in the experimental group were enrolled in the depression multidisciplinary cooperation group and received the whole course of MTM intervention. After 6 months of intervention, the two groups were compared in three aspects: medication compliance, adverse drug reaction(ADR), and readmission rate. RESULTS Compared with the control group, after the intervention, the changes in the number of compliance levels of patients in the experimental group were significantly different(P<0.01), and the ADR score decreased(P<0.05). The readmission rate decreased, but the difference was not statistically significant(P>0.05). CONCLUSION The implementation of the whole-course medication therapy management model for depression based on multidisciplinary collaboration can improve medication compliance and adverse drug reactions, which has certain effects.