风湿性心脏病二尖瓣狭窄伴心房颤动患者应用全程路径式药学服务联合同伴教育的干预效果

Intervention Effect of Whole-course Pathway Pharmaceutical Care Combined with Peer Education in Patients with Rheumatic Heart Disease Mitral Stenosis and Atrial Fibrillation

目的:研究风湿性心脏病二尖瓣狭窄伴心房颤动患者应用全程路径式药学服务联合同伴教育干预的价值。方法:招募我院2020年9月—2023年9月收治的120例风湿性心脏病二尖瓣狭窄伴心房颤动患者,按随机数字表法分为观察组(全程路径式药学服务+同伴教育干预,n=60)和对照组(常规路径服务+同伴教育干预,n=60)。比较两组国际标准化比值(INR)达标率、住院时间、用药依从性、用药信念、再入院率、不良事件。结果:两组出院前INR达标率、住院时间、住院期间不良事件发生率比较,差异无统计学意义(P>0.05);观察组随访3个月时服药信念特异性问卷(BMQ)、Morisky用药依从性问卷(MMAS-8)得分高于对照组,INR达标率高于对照组,不良事件发生率、再入院率低于对照组,差异有统计学意义(P<0.05)。结论:全程路径式药学服务联合同伴教育干预有助于改善风湿性心脏病二尖瓣狭窄伴心房颤动患者近期预后,可提高用药依从性及用药信念,减少不良事件发生率及再入院率。

Objective:To study the value of whole-course pathway pharmaceutical care combined with peer education intervention in patients with rheumatic heart disease mitral stenosis and atrial fbrillation.Methods:A total of 120 patients with rheumatic heart disease mitral stenosis and atrial fbrillation admitted to our hospital from September 2020 to September 2023 were enrolled.They were divided into observation group(whole-course pathway pharmaceutical care+peer education intervention,n=60)and control group(routine path service+peer education intervention,n=60)according to the random number table method.The compliance rate of international normalized ratio(INR),hospitalization time,medication compliance,medication belief,readmission rate and adverse events were compared between the two groups.Results:There was no signifcant diference in INR compliance rate before discharge,hospitalization time and incidence of adverse events during hospitalization between the two groups(P>0.05).After 3 months of follow-up,the scores of medication belief specifc questionnaire(BMQ)and Morisky medication compliance questionnaire(MMAS-8)in the observation group were higher than those in the control group,the INR compliance rate was higher than that in the control group,the incidence of adverse events and readmission rate were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Whole-course path pharmaceutical care and peer education intervention can help improve the recent prognosis of patients with rheumatic heart disease,improve medication compliance and medication belief,and reduce the incidence of adverse events and readmission.