临床药师参与抗凝管理对非瓣膜性房颤患者口服华法林抗凝效果的影响

To investigate the effect of clinical pharmacists participating in anticoagulation management on oral warfarin anticoagulation in patients with non-valvular atrial fibrillation

目的 探讨非瓣膜性房颤患者在口服华法林的过程中临床药师参与抗凝管理对抗凝效果的影响。方法 选取2019年1月至2020年9月于我院收治的非瓣膜性房颤患者132例,随机抽取66例作为观察组,由临床药师、护士和住院医生联合抗凝管理,另外66例作为对照组,由住院医生、主管护士在住院期间进行常规抗凝管理。探究两组间华法林抗凝管理的效果和安全。结果 观察组患者的INR(国际标准化比值)达标率高于对照组,差异有统计学意义(χ^(2)=8.19,P<0.05);观察组患者服用华法林的依从性(89.39%)优于对照组(57.56%),差异具有统计学意义(χ^(2)=17.94,P<0.001);出血性事件发病率观察组(9.09%)则低于对照组(31.82%),差异具有统计学意义(χ^(2)=4.59,P<0.05)。结论 临床药师参与抗凝管理可以显著提升非瓣膜房颤患者抗凝效果与安全,应当加强临床药师对抗凝防治的监护管理。

Objective To explore the effect of clinical pharmacists′ participation in anticoagulation management on the anticoagulation effect of oral warfarin in patients with non-valvular atrial fibrillation.Methods From 132 patients with non-valvular atrial fibrillation admitted to our hospital from January 2019 to September 2020,66 cases were randomly selected as the observation group,receiving joint anticoagwlation management by clinical pharmacists,nurses and residents.The other 66 cases were selected as the control group,receiving routine anticoagulation management by residents and nurses during hospitalization.The intervention of anticoagulant drug monitoring by clinical pharmacists was conducted to explore the effect and safety of warfarin anticoagulation management.Results The INR compliance rate of the observation group patients is higher than that of the control group,and the difference is statistically significant(χ^(2)=8.19,P<0.05);The compliance of patients taking warfarin in the observation group(89.39%) was better than that in the control group(57.56%),and the difference was statistically significant(χ^(2)=17.94,P<0.001);The incidence rate of bleeding events in the observation group(9.09%) was lower than that in the control group(31.82%),with a statistically significant difference(χ^(2)=4.59,P<0.05).Conclusion The participation of clinical pharmacists in anticoagulation management service can significantly improve the efficacy and safety of anticoagulation in patients with NVAF.Therefore,it is necessary to strengthen the monitoring and management service of clinical pharmacists for anticoagulation prevention and treatment.