家庭医生签约制度下药学服务在社区老年慢性病患者疾病管理中的应用效果观察

Observation on the application effect of pharmacy care in the disease management of elderly chronic disease patients in the community under the family doctor contracting system

目的分析家庭医生签约制度下药学服务在社区老年慢性病患者疾病管理中的应用效果。方法400例老年慢性病患者,随机分为对照组和观察组,每组200例。对照组患者实施常规药学服务,观察组患者实施家庭医生签约制度下药学服务。对比两组患者的慢性疾病相关知识掌握程度评分,疾病危险因素控制情况,生活质量评分,用药依从性,药物不良反应发生情况。结果干预前,两组患者的慢性疾病相关知识掌握程度评分比较差异无统计学意义(P>0.05);干预6个月后,两组患者的慢性疾病相关知识掌握程度评分均显著高于本组干预前,且观察组患者的慢性疾病相关知识掌握程度评分(81.23±6.11)分明显高于对照组的(70.23±6.23)分,差异具有统计学意义(P<0.05)。干预6个月后,观察组患者按时用药、定时复查、合理饮食、合理作息、运动习惯、不吸烟饮酒占比分别为86.00%、88.00%、86.50%、92.50%、89.00%、79.00%,均显著高于对照组的78.50%、80.50%、79.00%、86.00%、82.00%、69.50%,差异具有统计学意义(P<0.05)。干预6个月后,观察组患者的躯体功能、心理功能、社会功能、物质生活评分分别为(73.32±5.22)、(72.62±6.36)、(73.06±5.18)、(83.11±6.16)分,均显著高于对照组的(62.89±5.26)、(62.93±6.23)、(62.82±5.13)、(72.92±6.18)分,差异具有统计学意义(P<0.05)。干预6个月后,观察组用药依从性80.00%显著高于对照组的65.50%,差异具有统计学意义(P<0.05)。干预6个月后,观察组药物不良反应发生率6.50%显著低于对照组的16.00%,差异具有统计学意义(P<0.05)。结论家庭医生签约制度下药学服务可提升社区老年慢性病患者对疾病相关知识掌握程度,有利于疾病的控制,并提升患者生活质量及对疾病危险因素控制能力,降低药物不良反应。

Objective To analyze the application effect of pharmacy care in the disease management of elderly chronic disease patients in the community under the family doctor contracting system.Methods A total of 400 elderly patients with chronic diseases were randomly divided into control group and observation group,with 200 cases in each group.The control group received routine pharmaceutical care,and the observation group received pharmaceutical care under the family doctor contracting system.The scores of mastery of chronic disease-related knowledge,control of disease risk factors,quality of life score,medication compliance,and adverse drug reactions were compared between the two groups.Results Before intervention,there was no statistically significant difference in the score of mastery of chronic disease-related knowledge between the two groups(P>0.05).After 6 months of intervention,the score of mastery of chronic disease-related knowledge in both groups was significantly higher than that before intervention in this group,and the score of mastery of chronic disease-related knowledge of(81.23±6.11)points in the observation group was significantly higher than that of(70.23±6.23)points in the control group.The differences were statistically significant(P<0.05).After 6 months of intervention,the proportions of regular medication,regular review,reasonable diet,reasonable work and rest,exercise habits,non-smoking and alcohol consumption in the observation group were 86.00%,88.00%,86.50%,92.50%,89.00%and 79.00%,which were significantly higher than those of 78.50%,80.50%,79.00%,86.00%,82.00%and 69.50%in the control group,and the differences were statistically significant(P<0.05).After 6 months of intervention,the scores of physical function,psychological function,social function and material life in the observation group were(73.32±5.22),(72.62±6.36),(73.06±5.18)and(83.11±6.16)points,which were significantly higher than those of(62.89±5.26),(62.93±6.23),(62.82±5.13)and(72.92±6.18)points in the control group,and the differences were statistically significant(P<0.05).After 6 months of intervention,the medication compliance of 80.00%in the observation group was significantly higher than that of 65.50%in the control group,and the difference was statistically significant(P<0.05).After 6 months of intervention,the incidence of adverse drug reactions of 6.50%in the observation group was significantly lower than that of 16.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Pharmaceutical care under the family doctor contracting system can improve the mastery of disease-related knowledge of elderly chronic disease patients in the community,which is conducive to disease control,improve the quality of life of patients and their ability to control disease risk factors,and reduce adverse drug reactions.