药物治疗管理服务对门诊慢病患者干预效果评价

Evaluation of intervention effects of drug therapy management service in outpatients with chronic diseases

目的:探讨药物治疗管理(MTM)服务对门诊老年慢病患者的干预效果。方法:选取上海市浦东新区公立医院2018年1月至2019年6月药学门诊收治的160名患有高血压或/和糖尿病老年慢病患者,随机分为干预组和对照组。对照组接受普通药物咨询,干预组至少在药学门诊实施1次完整MTM服务,随访时间不少于6个月。利用经济、临床和人文产出(ECHO)模型及药物治疗相关问题(DRPs)的改善评价药师MTM服务前后的效果。结果:入组6个月后,干预组在改善经济结果、临床结局、人文评价、解决药物相关问题(DRPS)方面与对照组有显著性差异。结论:MTM可以通过识别和干预药物治疗相关问题、及时发现和解决药物不良反应,改善患者依从性,从而提高药物治疗效果和安全性。MTM能以较低的成本提高患者的临床疗效和生活质量,患者对MTM服务的效果满意,在高血压/糖尿病等疾病治疗中有较好的作用,可推广应用,使更多患者受益。

OBJECTIVE To investigate the intervention effects of new drug therapy management(MTM)service mode in elderly oatients with chronic diseases in pharmacy clinic.METHODS A total of 160 elderly patients with chronic diseases(hypertension or/and diabetes)were selected from pharmacy clinic of Shanghai Pudong New District Gongli Hospital in January 2018 to June 2019,and randomly divided into intervention group and control group.The control group received general drug counseling,and the intervention group received complete MTM service at least once in the pharmacy clinic,and the follow-up time was not less than 6 months.The intervention effects before and after service were evaluated by using the pharmacoeconomic evaluation model ECHO(economic,clinical,and human outcomes)and changes in pharmacotherapy-related problems(DRPs).RESULTS Six months after enrollment,the intervention group showed significant differences in improving economic outcomes,clinical outcomes,human evaluation and resolving drug-related problems(DRPs).CONCLUSION MTM can improve the efficacy and safety of drug therapy through the identification and intervention of drug treatment-related problems,timely detection and resolution of adverse drug reactions and the improvement of patient’s compliance.The study have showed that MTM improved patient’s clinical outcomes and quality of life with reduced costs,and patients were satisfied with MTM service.MTM service benefits the disease treatment and drug management of patients with hypertension or/and diabetes,which can be popularized in order to benefit more patients.