门诊骨质疏松症患者药物治疗管理模式的探索

Exploration of the medication therapy management model for outpatients with osteoporosis

目的评估实施药物治疗管理(medication therapy management,MTM)对骨质疏松症患者用药依从性和症状改善的影响,建立医院MTM服务模式。方法将258例骨质疏松症患者随机分为干预组和对照组,每组129例。干预组接受常规医疗服务和规范MTM,对照组仅接受常规医疗服务。比较2组患者用药后的骨密度值、骨标志物值、生命质量、疼痛程度、用药依从性和不良反应发生率。结果干预组患者的骨密度值、骨标志物值、生命质量评分和用药依从性评分均显著高于对照组(P<0.05),疼痛程度评分及不良反应发生率均低于对照组(P<0.05)。结论该院已初步建立了标准化的门诊MTM工作模式,药师主导的MTM服务能有效提高骨质疏松症患者的生活质量和用药依从性,降低了药物不良反应的发生,发挥了临床药师的专业特长,值得深入探索。

Objective To explore the effect of medication therapy management(MTM)on medication adherence and symptom improvement in patients with osteoporosis,and to establish the medication therapy management services model in hospital.Methods Totally 258 patients with osteoporosis were randomly divided into intervention group and control group,with 129 cases in each group.The patients in the intervention group received routine treatment services and standardized MTM services.The patients in the control group only received routine treatment services.The bone mineral density(BMD),bone markers,quality of life scores,degree of pain scores,medication compliance scores and adverse drug reaction(ADR)incidence were compared between the 2 groups.Results After treatment,the BMD,bone markers,quality of life scores,medication compliance scores of osteoporosis outpatients in the intervention group were significantly improved(P<0.05),and the degree of pain scores and adverse drug reaction incidence were reduced when compared with the control group(P<0.05).Conclusion The hospital has preliminarily established its own model of MTM for outpatients.Pharmacists implement MTM service for patients with osteoporosis can improve the quality of life and medication compliance scores,as well as reduce the ADRs incidence.MTM service reflects the pharmacist’s professional expertise which needs to be further studied.