“互联网+”药学服务联合常规用药指导用于慢性阻塞性肺疾病患者健康管理效果分析

Application Effect of″Internet+″Pharmaceutical Care Combined with Conventional Medication Guidance in the Health Management of Patients with Chronic Obstructive Pulmonary Disease

目的探讨“互联网+”药学服务联合常规用药指导用于慢性阻塞性肺疾病(COPD)患者健康管理的效果。方法选取广东省佛山市第四人民医院综合呼吸科2018年1月至2019年12月收治的COPD住院患者570例,按随机数字表法分为观察组和对照组,各285例。出院后,两组患者均予常规用药指导,观察组加用“互联网+”药学服务模式,内容包括药师通过手机App提供服药计划、按时用药提醒、用药记录等方面的健康管理指导。两组患者均随访12个月。结果失访56例(观察组30例、对照组26例),均予剔除。出院后,观察组患者对药物治疗作用、药品用法、药品不良反应(ADR)及其防治方法、气雾剂使用方法的知晓率均显著高于对照组(P<0.05)。观察组ADR发生率为18.82%,显著低于对照组的39.00%(P<0.05)。观察组患者咳嗽、咳痰、呼吸功能评分均显著低于对照组,早、晚呼气峰流速均显著高于对照组(P<0.05)。观察组患者急性加重期、稳定期用药种类均显著少于对照组,按时用药率、按规定剂量用药率、药品说明书参阅率均显著高于对照组(P<0.05)。观察组患者年就诊次数、年住院率、年就诊费用均显著低于对照组(P<0.05)。观察组患者的满意度和自我效能感评分均显著高于对照组(P<0.05)。结论“互联网+”药学服务联合常规用药指导用于COPD患者的健康管理,可有效提高患者对疾病和药物的认识,减少ADR的发生,改善病情,减少用药种类,降低用药成本。

Objective To investigate the application effect of″Internet+″pharmaceutical care combined with conventional medication guidance in the health management of patients with chronic obstructive pulmonary disease(COPD).Methods A total of 570 inpatients with COPD admitted to the Department of Comprehensive Respiratory in the Fourth People's Hospital of Foshan from January 2018 to December 2019 were selected and divided into the observation group and the control group by the random number table method,with 285 cases in each group.After discharge,the patients in the control group were given the conventional medication guidance,on this basis,the patients in the observation group were given the″Internet+″pharmaceutical care,including medication plan,timely medication reminder,medication record and other health management guidance provided by pharmacists through mobile App.Both groups were followed up for 12 months.Results Fifty-six cases were lost to follow up(30 cases in the observation group and 26 cases in the control group),and all excluded.After discharge,the awareness rate of drug treatment effect,drug usage,adverse drug reaction(ADR),its prevention and treatment method and use method of aerosol in the observation group was significantly higher than that in the control group(P<0.05).The incidence of ADR in the observation group was 18.82%,which was significantly lower than 39.00%in the control group(P<0.05).The cough,expectoration and respiratory function scores in the observation group were significantly lower than those in the control group,and the peak expiratory flow(PEF)in the morning and evening in the observation group was significantly higher than that in the control group(P<0.05).The medication variety in the observation group during the acute and stable periods of disease was significantly less than that in the control group,the timely medication rate,the medication rate according to the prescribed dose and the reference rate of drug instructions in the observation group were significantly higher than those in the control group(P<0.05).The annual consultation frequency,annual hospitalization rate and annual medical costs in the observation group were significantly lower than those in the control group(P<0.05).The satisfaction level and self-efficacy score in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The application of″Internet+″pharmaceutical care combined with conventional medication guidance in the health management of patients with COPD can effectively improve patients'awareness for diseases and drugs,decrease the occurrence of ADR,improve the disease condition,decrease the medication variety and costs.