远程药学管理模式联合延续护理在2型糖尿病合并冠状动脉病变患者居家用药中的研究

Study on home medication of type 2 diabetes patients with coronary artery disease by remote pharmaceutical management mode combined with continuous nursing

目的探讨远程药学管理模式联合延续护理在2型糖尿病(T2DM)合并冠状动脉病变患者居家用药中的应用效果。方法选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表(SF-36)]及心血管事件发生情况。结果研究组用药、饮食、运动依从性均高于常规组(P<0.05)。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组(P<0.05)。相较于干预前,两组患者在干预后的活力(VT)、精神健康(MH)、情感职能(RE)、躯体疼痛(BP)、生理功能(PF)、社会功能(SF)、生理职能(RP)、总体健康(GH)分值均升高,且研究组高于常规组(P<0.05)。研究组与常规组患者心血管不良事件发生率分别为2例(2.00%)、15例(15.09%),研究组高于常规组(χ2=10.865,P<0.05)。结论远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。

Objective To explore the application effect of remote pharmacy management mode combined with continuous nursing in the home medication of type 2 diabetes mellitus(T2DM)patients with coronary artery disease.Methods A total of 200 patients with T2DM complicated with coronary artery diseases who were diagnosed and treated in the Third Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2023 were selected as the study subjects.They were divided into a conventional group of 100 patients and a study group of 100 patients based on different intervention methods.The patients in the conventional group received routine care both in and out of the hospital,while the study group received remote pharmaceutical management mode combined with continuous care on the basis of the conventional group.Patient medication compliance,dietary compliance,exercise compliance,self-management ability,quality of life[36 item concise health scale(SF-36)]and incidence of adverse cardiovascular events were assessed.Results The compliance of medication,diet and exercise in the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the self-management function,sense of responsibility,self-concept and health knowledge scores of both groups of patients were significantly increased after intervention,and the scores of the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the Vitality(VT),Mental Health(MH),Emotional Function(RE),Physical Pain(BP),Physiological Function(PF),Social Function(SF),Physiological Function(RP)and Overall Health(GH)scores of both groups of patients were significantly increased after intervention,and the scores of the study group was significantly higher than those of the conventional group(P<0.05).The incidence of cardiovascular adverse events in the study group and the conventional group were 2 cases(2.00%)and 15 cases(15.09%),respectively,with the study group significantly higher than the conventional group(χ2=10.865,P<0.05).Conclusions The combination of remote pharmaceutical management mode and continuous care can significantly improve the medication management compliance of T2DM patients with coronary artery disease,improve their self-management ability,improve the quality of their life and reduce the incidence of adverse cardiovascular events.