药物治疗管理在老年慢性阻塞性肺疾病急性加重期患者中的应用与评价

Practice and evaluation of medication therapy management for elderly patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨在老年患者慢性阻塞性肺疾病急性加重期(AECOPD)及预后中开展药物治疗管理的价值。方法选取2021年10月至2022年3月于南京中医药大学第二附属医院肺病科接受治疗的AECOPD患者,按随机数学表法将患者分为两组,对照组进行常规管理,研究组予以常规管理和药师主导的药物治疗管理,并在出院时评估患者满意度。分别在危险窗(出院3个月)和6个月后从临床[慢性阻塞性肺疾病患者自我评估测试(CAT)评分、急性加重再入院情况]、人文(用药依从性、吸入剂使用技术与疾病认知度、满意度)和药物相关问题(DRPs)解决数量3个层面对比两种管理模式的差异。结果共纳入60例AECOPD患者,对照组和研究组各30例,研究组患者在随访期内再入院率明显低于对照组,且CAT评分下降幅度更为明显(P<0.05)。两组人文结局和解决DRPs方面比较,差异均有统计学意义(P<0.05),但两组患者满意度相近(P>0.05)。结论在老年AECOPD患者中开展药物治疗管理可以显著提高临床疗效,有助于患者自我管理。

Objective To investigate the value of medication therapy management(MTM)for elderly patients with acute exacerbation of acute exacerbation of chronic obstructive pulmonary(AECOPD)and their prognosis.Methods Select AECOPD patients who received treatment from the Department of Pulmonary,the Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from October 2021 to March 2022 were selected and divided into two groups according to random number table method.The control group received routine management,the study group was provided with MTM on basis of routine management,and patient satisfaction was investigated at discharge.The differences between the two groups were compared from three aspects during AECOPD risk window(3 months)and 6 months following hospital discharge,which were clinical(CAT score and readmission of acute exacerbation),humanities(medication compliance,inhaler use technique and familiarization of disease,satisfaction of management)and the number of drug-related problems(DRPs)resolved.Results A total of 60 AECOPD patients were included,30 patients in the control group and 30 patients in the study group.The readmission rate of the study group was significantly lower than that of the control group during the follow-up period,and the decrease of CAT score was more significant(P<0.05).There were statistically significant differences in humanistic outcomes and DRPs resolution between the two groups(P<0.05),but patient satisfaction was similar between the two groups(P>0.05).Conclusion MTM can improve clinical efficacy and self-management ability of elderly patients with AECOPD.