护士主导的药物治疗管理在医院-家庭过渡期老年糖尿病患者规范性用药中的应用效果

Application Effect of Nurse-Led Medication Therapy Management for Standard Medication in Elderly Diabetic Mellitus Patients During Hospital-Family Transition Period

目的观察护士主导的药物治疗管理(MTM)在医院-家庭过渡期老年糖尿病患者规范性用药中的应用效果。方法选取2020年3—9月于河南大学第一附属医院内分泌科住院治疗的260例老年糖尿病患者,采用随机数表法分为对照组和MTM组,各130例。对照组接受常规出院前用药指导,院外电话随访每月1次,共3次。MTM组接受护士主导MTM服务,按药物治疗回顾、干预和/或提出参考意见及交流3个阶段进行用药管理。比较两组患者出院3个月内用药差异的发生率及服药依从性的变化。结果出院3个月内,MTM组服药次数增加、服药次数减少、漏服药物、服药剂量减少、服药时间错误、未规律服药及服药种类减少的用药差异发生率低于对照组(P<0.05)。两组干预前MMAS-8评分比较,差异无统计学意义(P>0.05);两组患者干预后MMAS-8评分均较干预前升高(P<0.05),且MTM组高于对照组(P<0.05)。结论护士主导的MTM可以降低医院-家庭过渡期老年糖尿病患者的用药差异发生率,提高患者的服药依从性。

Objective To observe the application effect of nurse-led medication therapy management(MTM)for standard medication in elderly diabetic mellitus patients during hospital-family transition period.Methods A total of 260 elderly diabetic mellitus patients who were treated in Department of Endocrinology of the First Affiliated Hospital of Henan University from March to September 2020 were selected,and they were divided into control group and MTM group by random number table,with 130 cases in each group.The control group received routine medication guidance before discharge,and out-of-hospital telephone follow-up was conducted once a month,a total of 3 times.MTM group received the MTM mode led by nurses,and medication management was carried out according to three stages:drug treatment review,intervention and/or reference and communication.The incidence change of medication discrepancy and medication compliance were compared between the two groups after dischange for 3 months.Results After discharge for 3 months,the incidence change of medication discrepancy of frequency of taking medication increased,the frequency of taking medication decreased,missed taking medication,the dose of taking medication decreased,the time of taking medication incorrectly,irregular taking medication and the type of taking medication decreased in MTM group were lower than those in control group(P<0.05).There were no statistically differences in MMAS-8 scores between the two groups before intervention(P>0.05).After intervention,the MMAS-8 scores in two groups were higher than those before intervention(P<0.05),and the score in MTM group was higher than that in control group(P<0.05).Conclusion Nurse-led MTM can reduce the incidence of medication discrepancy in elderly diabetic mellitus patients during hospital-family transition period,and improve medication compliance of patients.