缺血性脑卒中患者慢病管理路径的建立及应用

Establishment and Application of Chronic Disease Management Pathway for the Patients with Ischemic Stroke

目的:建立缺血性脑卒中患者慢病管理(CDM)路径,为神经内科临床药师开展药学监护提供新思路。方法:应用临床路径的原理和方法,按脑卒中药物治疗特点,以循证医学为依据制定脑卒中药物监护内容与路径。以临床药师为主导的临床医生、护士共同参与的药物治疗团队对50例缺血性脑卒中患者进行CDM,内容包括住院期间的CDM及出院后的随访。并与50例常规治疗模式的患者进行比较。结果:经过CDM的患者在6个月后随访时,生活方式改善率、对药物的认识,用药依从性、危险因素控制等方面均明显优于常规治疗患者。结论:临床药师参加CDM可明显提高CDM的效果。

Objective:Establish a chronic disease management(CDM)path in patients with ischemic strokes,to provide the new idea for clinical pharmacists providing pharmaceutical care in neurology department.Methods:Applying the principles and methods of clinical pathway,according to the characteristics of stroke drugs,on the basis of evidencebased medicine,the care contents of were established,and the pharmaceutical care pathway as formed.The care team was led by a clinical pharmacist,including doctors and nurses,CDM of 50 patients with ischemic strokes.CDM work has been compised of two parts:chronic disease management during hospitalization and follow-up after discharge.And opposed to 50 patients with conventional treatment mode.Results:After 6 months of follow-up,patients with CDM were significantly better than conventional patients in terms of lifestyle improvement rate,drug understanding,drug compliance,and risk factor control.Conclusion:Clinical pharmacists’participation in CDM improved clinical effect.