药物治疗管理服务模式在腹膜透析患者中的应用效果分析

Analysis of the Effectiveness of Medication Therapy Management Service Model in Peritoneal Dialysis Patients

目的:分析药物治疗管理(MTM)服务模式在腹膜透析患者中的应用效果。方法:选取2021年1—12月大理大学第一附属医院肾内科收治的行腹膜透析患者112例作为研究对象,通过随机数字表法分为干预组和对照组,各56例。对照组接受常规化用药指导,干预组由临床药师给予MTM服务。比较两组患者接受干预6个月后的用药依从性、不合理用药发生情况和MTM服务成效。结果:干预6个月后,干预组用药依从性评分明显高于对照组,差异有统计学意义(P<0.001);干预组患者药物用法用量不适宜、无适应证用药、用药疗程不适宜、重复用药、用药时间不适宜、联合用药不适宜发生率均低于对照组,差异有统计学意义(P<0.05)。干预组药物不良反应发生率、腹膜炎感染发生率、6个月内再入院率均低于对照组,血糖达标率、血压达标率、钙磷代谢达标率均高于对照组,差异有统计学意义(P<0.05)。结论:通过对腹膜透析患者实施MTM,可以提高患者用药依从性和安全性,改善药物治疗效果。

Objective:To analyze the effectiveness of the medication therapy management(MTM)service model in peritoneal dialysis patients.Methods:One hundred and twelve patients on peritoneal dialysis admitted to the Department of Nephrology,the First Affiliated Hospital of Dali University from January to December 2021 were selected as study subjects and divided into intervention and control groups by random number table method,with fifty-six cases each.The control group received conventional medication guidance,while the intervention group was given MTM service by the clinical pharmacist.The medication compliance,the occurrence of irrational medication usage and the effectiveness of MTM service were compared between the two groups after 6 months of intervention.Results:After 6 months of intervention,the medication adherence score of the intervention group was significantly higher than that of the control group,and the difference was statistically significant(P<0.001).The incidence of inappropriate medication dosage,medication without indication,inappropriate medication regimen,repeated medication,inappropriate medication duration,and inappropriate combination medication was lower in the intervention group than in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse drug reactions,incidence of peritonitis infection,and readmission rate within 6 months were lower in the intervention group than in the control group,and the rates of blood glucose compliance,blood pressure compliance,and calcium and phosphorus metabolism compliance were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:By implementing MTM in peritoneal dialysis patients,it can improve patients'medication compliance and safety,and improve the effect of drug therapy.