药师干预口服抗肿瘤药患者用药依从性的成效分析

Effectiveness Analysis of Pharmacists′Intervention on Medication Compliance in Patients Treated with Oral Anti-Tumor Drugs

目的评价药师干预口服抗肿瘤药物患者用药依从性的成效。方法采用计算机检索PubMed,Web of Science,Embase及中国知网、维普和万方医学数据库中药师对口服抗肿瘤药物患者用药依从性进行干预的相关研究,检索时限为自建库起至2022年4月1日。采用Cochrane偏倚风险评价工具RoB2进行偏倚风险评价,采用RevMan 5.4软件进行Meta分析,无法进行Meta分析的结局指标进行描述性统计。结果共纳入8项随机对照试验(RCT),涉及患者717例。常见的用药依从性干预措施为定期随访、用药教育和咨询。测量方法包括直接评估法和间接评估法,其中直接评估法通过测量血药浓度;间接评估法包括客观评估法(药片计数法和电子监测设备)和主观评估法(患者问卷调查)。4项以患者是否依从用药二分类变量为结局指标的RCT的Meta分析结果显示,药师对口服抗肿瘤药物患者进行药学干预可显著提高其用药依从性[OR=4.59,95%CI(1.09,19.29),P=0.04];亚组分析结果显示,采用主观评估法评估用药依从性的研究中,干预组的用药依从性显著提高[OR=6.84,95%CI(2.84,16.50),P<0.0001]。结论药师积极对口服抗肿瘤药物患者进行药学干预,可提高患者的用药依从性。

Objective To evaluate the effectiveness of pharmacist′s intervention on medication compliance in patients treated with oral anti-tumor drugs.Methods Studies related to pharmacists′intervention on medication compliance in patients treated with oral anti-tumor drugs in the PubMed,Web of Science,Embase,CNKI,VIP,and WanFang databases were searched from their inception to April 1,2022.The Cochrane bias risk assessment tool RoB2 was used for bias risk assessment,and the RevMan 5.4 software was used for Meta-analysis.Descriptive statistics were conducted on outcome indicators that Meta-analysis was not available.Results Eight randomized controlled trials(RCTs)were included,involving 717 patients.Common medication compliance interventions included regular follow-up,medication education and counseling.The measurement methods included the direct evaluation and indirect evaluation.Direct evaluation was conducted by measuring the blood drug concentration,and the indirect evaluation method included objective evaluation methods(tablet counting method and electronic monitoring equipment)and subjective evaluation methods(patient questionnaire survey).Meta-analysis results of four RCTs with binary variables of patients′medication compliance as outcome indicators showed that pharmacists′pharmacological intervention for patients treated with oral anti-tumor drugs can significantly improve their medication compliance[OR=4.59,95%CI(1.09,19.29),P=0.04].Subgroup analysis results showed that patients′medication compliance in the intervention group significantly improved in studies related to the subjective evaluation method used for evaluating medication compliance[OR=6.84,95%CI(2.84,16.50),P<0.0001].Conclusion Pharmacists′active intervention for patients treated with oral anti-tumor drugs can improve their medication compliance.