糖尿病远程居家药学服务的实践及效果评价

Practice and Effect Evaluation of Telemedicine-Home-Based Pharmaceutical Service for Patients with Diabetes

目的:探索临床药师基于“互联网+药学服务”对糖尿病患者开展居家药学服务的工作模式,评价患者接受药学服务的效果。方法:选取本院2020年10月~2021年2月内分泌病区出院的102例居家糖尿病患者为研究对象,临床药师通过互联网服务平台为患者提供6个月的居家药学服务。于服务后第1、3和6个月进行随访,统计居家药物治疗相关问题的数量,服务前后血糖达标率、不良反应发生率、对药物的了解程度、Morisky用药依从性量表(MMAS-8)评分和患者生活方式的改善情况,评估居家药学服务的实施效果。结果:共计为居家糖尿病患者提供168次药学服务。服务6个月后,患者对药物的了解程度、用药依从性差和不良反应发生率分别由2.47分、26.47%、12.75%下降至1.48分、12.75%、3.92%;生活方式改善和空腹血糖达标率分别由10.78%、76.47%提高至71.57%和95.10%,具有统计学差异(P<0.05)。结论:临床药师通过互联网服务平台针对糖尿病患者开展居家药学服务,可有效改善患者空腹血糖达标率、对药物的了解程度、用药依从性及不良生活方式,从而减缓糖尿病患者并发症的发生。

Objective:To explore the clinical pharmacist-home-based pharmaceutical care model for patients with diabetes by Internet+pharmaceutical service platform and to evaluate the outcomes of pharmaceutical care for these patients.Methods:A total of 102 patients with diabetes at home who were discharged from secretory ward of our hospital from October 2020 to February 2021 were selected as the research objects.Clinical pharmacists provided 6-month home-based pharmaceutical services to patients on the internet service platform.Follow-ups were conducted at 1,3,and 6 months after management to count the number of problems related to home drug treatment,the standard rate of blood glucose before and after management,the incidence of adverse reactions,the level of understanding of medications,as well as the score according to Morishy Medication Compliance Scale(MMAS)-8 and the improvement of the patient’s lifestyle,to evaluate the effect of home-based pharmaceutical services.Results:A total of 168 times of pharmaceutical care were provided for diabetic patients at home.After 6 months of management,the patients’understanding of the drug,poor medication adherence,and incidence of adverse reactions decreased from 2.47 points,26.47%,12.75%to 1.48 points,12.75%,and 3.92%;lifestyle improvement and the standard rate of blood glucose increased from 10.78%,76.47%to 71.57%and 95.10%respectively,with statistically significant(P<0.05).Conclusion:Clinical pharmacists provide home-based pharmaceutical care by internet service platform,which can effectively improve the standard rate of blood glucose,understanding of drugs,medication adherence and poor lifestyle of diabetes,thus slowing down the occurrence of chronic complications.