呼吸与危重症医学咳喘药学服务在慢性阻塞性肺疾病中的应用

The application of pulmonary and critical care medicine cough and asthma pharmaceutical care in patients with chronic obstructive pulmonary disease

目的探究呼吸与危重症医学(PCCM)咳喘药学服务在慢性阻塞性肺疾病(COPD)病人中的应用效果。方法选取2022年1―11月在六安市人民医院就诊并接受咳喘药学服务的60例COPD病人为研究对象,采用自身对照法,观察PCCM咳喘药学服务对COPD病人干预前、干预后3个月及6个月后疾病控制效果[COPD评估测试(CAT)评分、呼吸困难量表(mMRC)分级]、用药依从性(MMAS-8)评分、吸入装置使用评分、不良反应发生率、急性发作/加重次数以及病人满意度等指标变化情况。结果与干预前相比,PCCM咳喘药学服务干预3个月、6个月CAT评分、mMRC分级均显著降低,MMAS-8评分、吸入装置使用评分、病人满意度显著升高,差异有统计学意义(P<0.05)。与干预前相比,干预3个月、干预3~6个月周期内病人不良反应发生率(31.7%比16.7%、13.3%)及急性发作/加重(≥2次)次数(26.7%比13.3%、10%)呈下降趋势,且差异有统计学意义(P<0.05)。结论PCCM咳喘药学服务能够有效提高COPD病人用药依从性,改善病人肺功能,促进COPD病人病情的稳定控制,值得临床推广应用。

Objective To explore the application effect of pulmonary and critical care medicine(PCCM)pharmacy care clinic in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 60 patients with COPD who were admitted to the Outpatient Department of Cough and Asthma Pharmaceutical Care in the Lu'an People's Hospital from January to November 2022 were selected as the study objects.Using self-control method,the changes of disease control effect(CAT score,mMRC grade),medication compliance score(MMAS-8),inhalation device use score,incidence of adverse reactions,acute attacks/exacerbations and patient satisfaction before intervention 3 months and 6 months after intervention in patients with COPD in PCCM pharmaceutical care outpatient clinic were observed.Results Compared with those before intervention,CAT score and mMRC grade of PCCM outpatient pharmacy care for cough and asthma at 3 months and 6 months were significantly decreased,while MMAS-8 score,inhalation device use score and patient satisfaction were significantly increased,the differences were statistically significant(P<0.05).Compared with the period before intervention,the incidence of adverse reactions(31.7%vs.16.7%,13.3%)and the number of acute attacks/exacerbations(≥2 times)during the 3 months and 3 to 6 months of intervention(26.7%vs.13.3%,10%)showed a decreasing trend.The difference was statistically significant(P<0.05).Conclusion PCCM pharmaceutical care can effectively improve the medication compliance of COPD patients,improve the lung function of patients,and promote the stable control of COPD patients,which is worthy of clinical promotion and application.