互联网药学服务路径管理模式对哮喘-慢性阻塞性肺疾病重叠综合征患者服药依从性及疾病控制情况的影响

Effect of Internet-Based Pharmaceutical Care Path Management Model on Medication Adherence and Disease Control in Patients with Asthma-Chronic Obstructive Pulmonary Overlap Syndrome

目的 探讨基于互联网药学服务路径管理模式对哮喘-慢性阻塞性肺疾病(COPD)重叠综合征(ACOS)患者服药依从性及疾病控制情况的影响。方法 选取医院门诊2021年5月至2023年5月收治的ACOS患者500例,根据干预模式的不同分为常规组(2021年5月至2022年4月门诊实施予常规药学服务管理方案,230例)和路径管理组(2022年5月至2023年5月门诊实施互联网药学服务路径管理模式,270例),均管理6个月。结果 路径管理组的不良反应发生率为9.26%,显著低于常规组的20.00%(P <0.05)。路径管理组患者的Morisky用药依从性问卷(MMAS-8)评分、抗菌药物使用强度、使用药物品种数、临床有效控制率[呼吸困难量表(mMRC)、COPD疾病评分法(CAT)]、住院时间、月均药品费用、月均住院总费用均显著低于常规组(P <0.05),用药信念调查问卷(BMQ)和哮喘安全控制评分法(ACT)均显著高于常规组(P <0.05)。路径管理组的药学服务满意度为82.22%,显著高于常规组的65.22%(P <0.05)。结论 基于互联网药学服务路径管理模式可明显提高ACOS患者的服药依从性和药学服务满意度,促进合理用药,增强用药信念感,有效控制病情,减少临床用药及住院费用,且安全性好。

Objective To investigate the effect of Internet-based pharmaceutical care path management model on medication adherence and disease control in patients with asthma-chronic obstructive pulmonary overlap syndrome(ACOS).Methods A total of 500 patients with ACOS admitted to the outpatient department of the hospital from May 2021 to May 2023 were selected and divided into the routine group(230 cases,implementation of the routine pharmaceutical care management plan in the outpatient department from May 2021 to April 2022) and the path management group(270 cases,implementation of the Internet-based pharmaceutical care path management model in the outpatient department from May 2022 to May 2023) according to the intervention mode.Both groups were managed for six months.Results The incidence of adverse reactions in the pathway management group was 9.26%,which was significantly lower than 20.00% in the routine group(P < 0.05).The 8-items Morisky Medication Adherence Scale(MMAS-8),Antibiotics Use Density(AUD),number of drug varieties,clinical effective control rate [modified Medical Research Council(mMRC),COPD assessment test(CAT)],length of hospital stay,average monthly drug costs,and average monthly total hospitalization costs in the pathway management group were significantly lower than those in the routine group(P < 0.05),while the Brief Medication Questionnaire(BMQ) and Asthma Control Test(ACT) scores in the pathway management group were significantly higher than those in the routine group(P < 0.05).The satisfaction rate of pharmaceutical care in the pathway management group was 82.22%,which was significantly higher than 65.22% in the routine group(P < 0.05).Conclusion The Internet-based pharmaceutical care path management model can significantly improve the medication adherence and satisfaction with pharmaceutical care in patients with ACOS,promote rational drug use,enhance the sense of medication belief,effectively control the disease,reduce clinical medication and hospitalization costs,and it has good safety.