临床药师开展慢病门诊药学服务的实践与探讨

Practice and discussion of pharmaceutical care by clinical pharmacists for outpatients with chronic disease

目的探讨临床药师对慢病门诊患者开展慢病药物治疗管理服务(MTMs)的实践模式,并对慢病患者接受药学服务的效果进行评价。方法选取2019年2月至2021年2月来慢病药学门诊就诊的226例患者为研究对象,临床药师通过互联网服务平台线上随访的方式为其提供MTMs。于管理后第1、3、6个月进行随访,统计药物治疗相关问题的数量,管理前后治疗目标达成率、对药物的了解程度、Morisky用药依从性量表(MMAS-8)的得分情况,评估药物治疗管理的实施效果。结果226例门诊患者提供298次MTMs。药物治疗管理6个月后,患者对药物的了解程度、用药依从性差由2.46分、26.11%下降至1.47分、12.83%;治疗达标率由69.91%提高至95.13%,差异有统计学意义(P<0.05)。结论临床药师针对慢病门诊患者开展长期药物治疗管理服务,可有效改善患者血压、空腹血糖达标率、对药物的了解程度及用药依从性,从而减缓慢性并发症的发生。

Objective To investigate the practice mode of chronic disease drug treatment management services(MTMS)by clinical pharmacists for outpatients with chronic disease,and to evaluate the effect of pharmaceutical care for chronic disease patients.Methods A total of 226 patients in chronic disease pharmacy clinic from February 2019 to February 2021 were selected as the research objects.Clinical pharmacists provide MTMS through online follow-up on the Internet service platform.Follow up was conducted at the first,third and sixth months after management to count the number of problems related to drug treatment,the achievement rate of treatment objectives before and after management,the degree of understanding of drugs,and the score of Morisky Medication Compliance Scale(MMAS-8),so as to evaluate the implementation effect of drug treatment management.Results The 226 outpatients were provided with 298 MTMS.After 6 months of drug treatment and management,the patients’understanding of drugs and poor medication compliance decreased from 2.46 and 26.11%to 1.47 and 12.83%;The standard rate of treatment increased from 69.91%to 95.13%,and the difference was significant(P<0.05).Conclusions Clinical pharmacists carry out long-term drug treatment management services for outpatients with chronic diseases,which can effectively improve patients’blood pressure,fasting blood glucose compliance rate,understanding of drugs and medication compliance,so as to slow down the occurrence of chronic complications.