临床药师主导的慢性病管理对老年高血压患者治疗效果的影响

Influence of chronic disease management led by clinical pharmacists on the treatment effect of elderly hypertensive patients

目的分析临床药师主导的慢性病管理对老年高血压患者治疗效果的影响。方法采用前瞻性研究方法,选取2016年1月—2019年12月江苏省句容市中医院住院高血压患者140例,根据随机数字表法分为观察组和对照组,每组70例。2组均根据《中国高血压基层管理指南》2014版高血压控制目标和治疗方案要求进行治疗,观察组在此基础上采取老年高血压患者慢性病管理。治疗3个月后比较2组治疗效果,治疗前后收缩压、舒张压、心率变化,不良反应及用药依从性。结果观察组治疗总有效率为95.71%,高于对照组的82.86%(χ^(2)=6.048,P=0.014);治疗3个月后,2组患者收缩压、舒张压、心率较治疗前均下降(P<0.05或P<0.01),且观察组收缩压、舒张压低于对照组(P<0.01),2组患者治疗后心率比较差异无统计学意义(P>0.05);观察组不良反应总发生率为2.86%,低于对照组的12.86%(χ^(2)=4.834,P=0.028);随访出院后3个月,2组用药依从性评分均明显降低,且观察组低于对照组(P均<0.01)。结论临床药师主导的慢性病管理可提高老年高血压患者的治疗效果,减少不良反应的发生,提高用药依从性。

Objective To explore the influence of chronic disease management led by clinical pharmacists on the treatment effect of elderly hypertensive patients.Methods A prospective study method was used to select 140 patients with hypertension who were hospitalized in Jurong Traditional Chinese Medicine Hospital from January 2016 to December 2019,and were divided into an observation group and a control group according to the random number table method,with 70 cases in each group.Both groups were treated according to the hypertension control goals and treatment plan requirements of the 2014 edition of the“Chinese Guidelines for Primary Management of Hypertension”,and the observation group was treated with chronic disease management of elderly hypertensive patients on this basis.After 3 months of treatment,the treatment effects of the two groups of patients were observed,the diastolic blood pressure,systolic blood pressure and heart rate levels before and after treatment,the incidence of adverse reactions to the treatment,and medication compliance.Results The total effective rate of the observation group was 95.71%,which was higher than 82.86%in the control group(χ^(2)=6.048,P=0.014).After 3 months of treatment,the systolic blood pressure,diastolic blood pressure and heart rate of the two groups were decreased compared with those before treatment(P<0.05 or P<0.01),and the systolic blood pressure and diastolic blood pressure of the observation group were lower than those of the control group(P<0.01);There was no significant difference in heart rate between patients after treatment(P>0.05).The total incidence of adverse reactions in the observation group was 2.86%,which was lower than 12.86%in the control group(χ^(2)=4.834,P=0.028).Follow-up 3 months after discharge,medication compliance scores in both groups were significantly decreased,and the observation group was lower than the control group(all P<0.01).Conclusion The chronic disease management led by clinical pharmacists can improve the treatment effect of elderly hypertensive patients,reduce the occurrence of adverse reactions,and improve medication compliance.