临床药师指导ARMS量表及SEAMS量表在老年慢性病长期用药患者中的应用

Application of ARMS scale and SEAMS scale under the guidance of clinical pharmacists in elderly patients with chronic disease

目的研究临床药师指导续配和服药依从性(ARMS)量表及合理用药效能(SEAMS)量表在老年慢性病长期用药患者中的应用价值。方法选择2018年3月至2019年5月广州市增城区人民医院收治的164例老年慢性病患者为研究对象,按照入院先后顺序分为研究组和对照组各82例,对照组患者入院后予以常规干预,研究组患者在对照组基础上联合临床药师指导。比较两组患者入院时及随访3个月后的ARMS量表和SEAMS量表评分,及世界卫生组织生存质量测量量表简表(WHOQOL-BREF)变化情况,并观察患者出院后3个月内的院外不合理医嘱用药情况、不良反应和再住院情况。结果出院后3个月,两组患者ARMS量表评分均较入院时降低,且研究组患者的ARMS量表评分为(14.22±1.02)分,明显低于对照组的(16.03±1.27)分,差异有统计学意义(P<0.05);出院后3个月,两组患者的SEAMS量表评分均较入院时上升,且研究组患者的SEAMS量表评分为(29.12±2.04)分,明显高于对照组的(27.06±2.37)分,差异有统计学意义(P<0.05);研究组患者院外总不合理医嘱用药率为2.44%,明显低于对照组的10.98%,差异有统计学意义(P<0.05);出院后3个月,两组患者的WHOQOL-BREF量表评分较入院时均上升,且研究组患者的环境领域、社会领域、心理领域和生理领域的各项评分均明显高于对照组,差异均有统计学意义(P<0.05);研究组患者的不良反应总发生率和再住院率分别为8.54%、2.44%,明显低于对照组的19.51%、10.98%,差异均有统计学意义(P<0.05)。结论ARMS量表和SEAMS量表可对老年慢性病长期用药患者进行针对性用药指导,提高患者用药依从性和合理用药效能,预防患者院外不合理医嘱用药。

Objective To study the application value of clinical pharmacists'guidance Adherence to Refills and Medications Scale(ARMS)and the SelfEfficacy for Appropriate Medication Use Scale(SEAMS)in elderly patients with chronic diseases.Methods A total of 164 elderly patients with chronic diseases,who admitted to Guangzhou Zengcheng District People's Hospital from March 2018 to May 2019,were selected and divided into research group and control group according to the order of admission,with 82 patients in each group.Patients in control group were received routine intervention after admission,and patients in the research group were guided by clinical pharmacists on the basis of the control group.The scores of ARMS scale,SEAMS scale,and the WHO Quality of Life Scale Abbreviated Version(WHOQOLBREF)at admission and 3 months after discharge were compared between the two groups.The unreasonable outofhospital medication,the adverse reactions and rehospitalization within 3 months after discharge were observed.Results Three months after discharge,the ARMS scale of the patients in both groups decreased compared with that on admission,and the ARMS scale score of the patients in the research group was(14.22±1.02)points,which was significantly lower than(16.03±1.27)points of the control group(P<0.05).Three months after discharge,the SEAMS scale scores of patients in both groups were higher than those on admission;the scores of SEAMS scale in the research group was(29.12±2.04)points,which was significantly higher than(27.06±2.37)points in the control group(P<0.05).The total irrational drug use rate of patients in the research group was 2.44%,which was significantly lower than 10.98%in the control group(P<0.05).Three months after discharge,the scores of WHOQOLBREF in both groups were increased compared with those on admission,and the scores of environmental field,social field,psychological field and physiological field in the study group were significantly higher than those in the control group(all P<0.05).The total incidence of adverse reactions and readmission rates in the research group were 8.54%and 2.44%,respectively,which were significantly lower than corresponding 19.51%and 10.98%in the control group(P<0.05).Conclusion ARMS scale and SEAMS scale can provide targeted medication guidance for elderly patients with chronic diseases,improve patients'medication compliance and rational drug use efficiency,and prevent patients from using unreasonable medical orders outside the hospital.