基于药师协议处方权对癌痛患者的管理

Study on the Pharmacists in the Management of Cancer Pain Patients According to the Protocol Prescribing Rights

目的探索临床药师在县级医院行使协议处方权管理癌痛患者的模式及管理效果干预性研究。方法选取2020年5月~2022年6月在药师门诊进行药师随访及协议处方权管理的40例患者作为干预组,同期在某院医生门诊进行癌痛药物治疗的35例患者作为对照组。结果随访60 d后,干预组中、重度疼痛占比由100%下降至27.5%,对照组中、重度疼痛占比由100%下降至65.7%,干预组疼痛评分显著低于同时期的对照组疼痛评分(P<0.05)。干预组较对照的便秘、恶心、呕吐等不良反应得到显著改善(P<0.05)。干预组用药依从性≥7分的患者占比由5%提高至67.5%,对照组观察用药依从性≥7分的患者占比由6.7%提高至31.4%,且干预组用药依从性高的患者比例显著高于同时期对照组(P<0.05)。干预组满意度评分中显著高于对照组(P<0.05)。结论临床药师利用协议处方权对癌痛患者进行治疗干预,可以缓解患者疼痛,减轻药物恶心、呕吐的不良反应,提高了患者用药依从性,为进一步管理门诊癌痛患者提供新的模式。

OBJECTIVE To explore the mode of clinical pharmacists exercising protocol prescribing rights to cancer pain patients management in a county-level hospital.METHODS A total of 40 patients who underwent protocol prescribing rights management in pharmacy clinic from May 2020 to June 2022 were selected as the intervention group,and 35 patients who received cancer pain drug treatment in doctors' clinic in a hospital during the same period were selected as the control group.RESULTS After 60 days,the proportion of moderate-severe pain in the intervention group decreased from 100% to 27.5%,and the proportion of moderate-severe pain in the control group decreased from 100% to 65.7%,and the pain score in the intervention group was significantly lower than that in the control group at the same period(P<0.05).In the intervention group,adverse reactions such as constipation,nausea and vomiting were significantly improved(P<0.05).The proportion of patients with medication compliance≥7 points in the intervention group increased from 5% to 67.5%,and the proportion of patients with medication compliance≥7 points in the control group increased from 6.7% to 31.4%,and the proportion of patients with high medication compliance in the intervention group was significantly higher than that in the control group at the same period.In addition,the satisfaction score of the intervention group was higher than that of the control group in terms of usage and dosage of the drug,the method of taking the medication and adverse reactions.CONCLUSION Clinical pharmacists use the protocol prescribing rights to treat and intervene the cancer pain patients,which can relieve the pain of patients,reduce the symptoms of drug nausea and vomiting,and improve the medication compliance of patients,indicating that this model is feasible and worthy of further promotion.