慢性阻塞性肺疾病患者咳喘药学门诊系统化药学服务干预效果研究

Intervention Effect of Systematic Pharmaceutical Care in Cough and Asthma Pharmacy Outpatient on Patients with Chronic Obstructive Pulmonary Disease

目的探讨基于药物治疗管理(MTM)的慢性阻塞性肺疾病(COPD)患者咳喘药学门诊系统化药学服务的效果。方法依托MTM服务理念,建立咳喘药学门诊服务流程。回顾性分析医院2021年1月至8月就诊的COPD稳定期患者的病历186份,按是否经咳喘药学门诊用药指导分为观察组(92例)和对照组(94例),随访6个月。比较两组患者干预后的肺功能、急性加重次数、药品不良反应发生率、慢性呼吸系统疾病问卷(CRQ)评分。结果该院形成了以专科药师干预为主的动态、全程、闭环咳喘门诊药学服务。与对照组比较,干预后观察组患者第1秒用力呼气容积(FEV1)占用力肺活量百分比(FEV1/FVC)、FEV1占预计值均明显提升[(51.73±5.31)%比(55.95±5.76)%,(50.53±9.50)%比(53.37±8.86)%,P<0.05],急性加重发生率明显降低(14.89%比5.43%,P<0.05),药品不良反应发生率明显降低(20.21%比9.78%,P<0.05),CRQ包括呼吸困难、疲劳症状、情感障碍、疾病控制评分及总评分均明显提升(P<0.05)。结论咳喘药学门诊系统化药学服务可操作性强,效果显著,能让COPD患者的疾病得到长期有效控制。

Objective To investigate the effect of systematic pharmaceutical care in the cough and asthma pharmacy outpatient on the patients with chronic obstructive pulmonary disease(COPD)based on the medication therapy management(MTM).Methods Based on the service concept of MTM,the process of pharmaceutical care in the cough and asthma pharmacy outpatient was established.A total of 186 medical records of patients with stable COPD admitted to the hospital from January to August 2021 were retrospectively analyzed.The above patients were divided into the observation group(92 cases)and the control group(94 cases)according to whether they received the medication guidance from the cough and asthma pharmacy outpatient.Both groups were followed up for six months.The lung function,the times of acute exacerbation,the incidence of adverse drug reactions and the score of chronic respiratory disease questionnaire(CRQ)were compared between the two groups after intervention.Results The hospital formed a dynamic,whole-process,closed-loop pharmaceutical care in the cough and asthma pharmacy outpatient dominated by the intervention of specialist pharmacists.After intervention,the forced expiratory volume in one second(FEV1)/forced vital capacity(FVC)in the observation group was(55.95±5.76)%,which was significantly higher than(51.73±5.31)%in the control group,and the predictive percentage of FEV1in the observation group was(53.37±8.86)%,which was significantly higher than(50.53±9.50)%in the control group.Compared with that in the control group,the incidence of acute exacerbation in the observation group was significantly lower after intervention(14.89%vs.5.43%,P<0.05).Compared with that in the control group,the incidence of adverse drug reactions in the observation group was significantly lower after intervention(20.21%vs.9.78%,P<0.05).Compared with those in the control group,the scores of dyspnea,fatigue symptom,emotional disorder,disease control and the total score of CRQ in the observation group were significantly higher after intervention(P<0.05).Conclusion The systematic pharmaceutical care in the cough and asthma pharmacy outpatient is feasible and effective,which can effectively control the disease of patients with COPD for a long time.