药学门诊高血压患者药物治疗管理服务体会

Experience of medication therapy management services for hypertension patients in pharmacy clinic

目的 为高血压患者开展药物治疗管理服务提供参考。方法 梳理分析本院药学门诊持续药物治疗管理服务的高血压病例,根据患者的心血管危险因素、靶器官损害以及临床并发症等情况,进行动脉粥样硬化性心血管疾病风险分层(分为低危、中危、高危和极高危4个层次),通过药学问诊、用药评估、方案调整、用药宣教、药学随访,建立患者药物治疗管理档案,为患者提供个体化药物治疗管理服务。结果 通过药学门诊药物治疗管理服务,患者相关的药物治疗问题得以有效解决,73例患者的血压、心率、低密度脂蛋白胆固醇、尿酸和同型半胱氨酸水平等动脉粥样硬化性心血管疾病危险指标达标率分别由药物治疗管理服务前的38.36%、61.64%、58.90%、65.75%、64.38%上升至药物治疗管理服务后的90.41%、89.04%、91.78%、87.67%、86.30%。结论 药师为高血压患者提供个体化的药物治疗管理服务,增强了患者的合理用药意识,提高了其用药依从性,进一步提升了药物治疗水平和临床治疗效果。

Objective To provide references for the development of medication therapy management(MTM)services for hypertension patients.Methods Hypertension patients who received MTM services in pharmacy clinic were sorted out and analyzed,and according to the specific conditions of patients′cardiovascular risk factors,target organ damage and clinical complications,the pharmacists stratified atherosclerotic cardiovascular disease(ASCVD)risk for each patient,which were divided into four levels:low risk,medium risk,high risk and extremely high risk.The pharmacists provided individualized MTM services for patients through pharmacy inquiry,medication evaluation,regimen adjustment,drug use education,pharmacy follow-up and establishing medical records.Results Through MTM services in the pharmacy clinic,the patients′related drug treatment problems were solved,the rate of reaching the standard of ASCVD risk indicators,such as blood pressure,heart rate,low-density lipoprotein cholesterol,uric acid and homocysteine,in 73 patients increased from 38.36%,61.64%,58.90%,65.75%and 64.38%before MTM services to 90.41%,89.04%,91.78%,87.67%and 86.30%after MTM services,respectively.Conclusion In the pharmacy clinic,the pharmacists provide individualized MTM services according to the specific conditions of hypertension patients,which enhances the patients′awareness of rational drug use,improves their medication compliance,and further improves rational drug use level and clinical treatment effect.