基于MTM的药学门诊服务在COPD患者中的应用

Application of MTM-based outpatient pharmaceutical service in patients with COPD

目的分析基于药物治疗管理(MTM)的药学门诊服务在慢性阻塞性肺疾病(COPD)患者中的应用效果。方法选取150例COPD患者,以随机数字表法分为对照组与MTM组,各75例。对照组实施常规门诊药学服务干预,MTM组实施基于MTM的药学门诊服务干预。比较两组患者干预期间用药时间依从率、用药剂量准确率、急性加重次数、药物不良反应发生率,干预前后肺功能[第一秒用力呼气量(FEV1)、最大通气量(MVV)、用力肺活量(FVC)]、圣乔治呼吸问卷(SGRQ)评分。结果干预期间,MTM组患者用药时间依从率92.00%、用药剂量准确率94.67%明显较对照组的76.00%、84.00%更高,急性加重次数(0.56±0.22)次、药物不良反应发生率4.00%明显较对照组的(0.79±0.36)次、13.33%更低(P<0.05)。干预后,两组患者FEV1、MVV、FVC均高于干预前,且MTM组FEV1(2.43±0.28)L、MVV(65.41±1.49)L/min、FVC(3.55±0.45)L较对照组的(2.18±0.33)L、(64.73±1.40)L/min、(3.34±0.43)L更高(P<0.05)。干预后,两组患者SGRQ中症状、活动、影响评分均低于干预前,且MTM组患者SGRQ中症状评分(40.13±4.29)分、活动评分(38.77±4.36)分、影响评分(39.95±4.60)分低于对照组的(42.07±4.61)、(41.13±4.55)、(42.32±4.78)分(P<0.05)。结论基于MTM的药学门诊服务干预应用于COPD患者中可有效提高其用药时间依从性和剂量准确率,降低疾病急性加重次数,有利于增强患者肺功能,并提高其生活质量。

Objective To analyze the application effect of medication therapy management(MTM)-based outpatient pharmaceutical service in patients with chronic obstructive pulmonary disease(COPD).Methods 150 patients with COPD were selected and divided into a control group and a MTM group by random number table method,with 75 cases in each group.The control group carried out conventional outpatient pharmaceutical service intervention,while the MTM group was given MTM-based outpatient pharmaceutical service intervention.Both groups of patients were compared in terms of compliance rate of medication time,accuracy rate of medication dose,the number of acute exacerbations and incidence of adverse drug reactions during intervention,the pulmonary function[forced expiratory volume in one second(FEV1),maximum ventilation volume(MVV),forced vital capacity(FVC)]and St.George's Respiratory Questionnaire(SGRQ)score before and after intervention.Results During intervention,the compliance rate of medication time and the accuracy rate of medication dose in MTM group were 92.00%and 94.67%,which were significantly higher than 76.00%and 84.00%in control group;the number of acute exacerbations and incidence of adverse drug reactions were(0.56±0.22)times and 4.00%,which were significantly lower than(0.79±0.36)times and 13.33%in control group(P<0.05).After intervention,FEV1,MVV and FVC in both groups were higher than those before intervention;MTM group had FEV1 of(2.43±0.28)L,MVV of(65.41±1.49)L/min and FVC of(3.55±0.45)L,which were higher than(2.18±0.33)L,(64.73±1.40)L/min and(3.34±0.43)L in control group(P<0.05).After intervention,the SGRQ score in both groups were lower than that before intervention;the SGRQ score for symptom,activity and impact were(40.13±4.29),(38.77±4.36)and(39.95±4.60)points,which were lower than(42.07±4.61),(41.13±4.55)and(42.32±4.78)points in control group(P<0.05).Conclusion MTM-based outpatient pharmaceutical service intervention for COPD patients can effectively improve the medication time and dose compliance,reduce the number of acute exacerbations,help to enhance the lung function,and improve the quality of life.