摘要
目的探讨临床药师对老年慢性阻塞性肺疾病(COPD)患者吸入制剂使用的干预效果。方法前瞻性将140例老年COPD患者按照随机数字表法分为对照组和研究组,每组70例,对照组给予常规用药宣教,研究组在对照组的基础上进行6个月的全程药学干预,比较两组患者对吸入剂药物知识掌握情况、吸入剂操作评分、错误操作发生率、疾病症状评分以及肺功能。结果与干预前比较,干预后两组患者吸入剂相关药学知识掌握评分均显著升高;两组间比较结果显示,研究组在吸入剂药理作用、使用方法、注意事项、不良反应以及掌握情况总分方面均高于对照组(t=5.905、7.064、5.356、5.211、19.600,均P<0.05)。两组患者吸入剂操作评分均随时间升高(F时间=64.259,P<0.05),研究组吸入剂操作评分升高幅度高于对照组(F时间×组间=5.237,P<0.05),研究组吸入剂操作评分整体水平高于对照组(F组间=7.218,P<0.05)。研究组患者吸入装置操作错误发生率低于对照组[5.7%(4/70)比18.6%(13/70),χ^2=5.423、(P=0.020)]。两组患者比较,研究组咳嗽、咳痰、气喘评分均低于对照组(t=11.602、9.282、11.225,均P<0.05),研究组FEV1%和FEV1/FVC均高于对照组(t=4.049、3.148,均P<0.05)。结论临床药师的药学干预提高了患者对于COPD的认识、吸入装置使用的正确率和依从性,从而缓解了患者的临床症状,改善了肺功能。
Objective To investigate the effect of pharmaceutical care intervention by clinical pharmacists on inhalant use in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 140 elderly patients with COPD were randomly divided into the control group(n=70,receiving conventional medicine education)and the study group(n=70,receiving the whole pharmaceutical care intervention as add-on to the treatment for control group for 6 months).The knowledge of inhalant medication,inhalant operation score,incorrect operation rate,disease symptom score and pulmonary function were compared between the two groups.Results Compared with pretreatment,the scores of inhalant knowledge were increased significantly in both groups after treatment.While,the scores in the pharmacology,usage,precautions,and adverse reactions as well as total scores were higher in the study group than in the control group(t=5.905,7.064,5.356,5.211 and 19.600,all P<0.05).The inhalant operation scores were significantly increased with time in both groups(Ftime=64.259,P<0.05).The increment of inhalant operation score was higher in the study group than in the control group(Ftime×group=5.237,P<0.05).The overall score of inhalant operation was higher in the study group than in the control group(Fgroup=7.218,P<0.05).The incorrect operation rate was lower in the study group than in the control group(5.7%or 4/70 vs.18.6%or 13/70,χ^2=5.423,P=0.020).The scores of cough,expectoration and asthma were lower in study group than in the control group(t=11.602,9.282 and 11.225,respectively,P<0.05).The percentage of the first second force expiratory volume to the estimated value(FEV1%)and FEV1/forced vital capacity(FVC)were higher in the study group than in the control group(t=4.049 and 3.148,all P<0.05).Conclusions Pharmaceutical care intervention improves patients'awareness of COPD,increases the accuracy and compliance of inhalant use,thus alleviates the clinical symptoms and improves lung function.
作者
朱虹
吴晓丽
秦海艳
张赟
秦孝峰
Zhu Hong;Wu Xiaoli;Qin Haiyan;Zhang Yun;Qin Xiaofeng(Department of Pharmacy,the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University,Jiangsu 223300,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2020年第3期264-268,共5页
Chinese Journal of Geriatrics
基金
江苏省药学会-天晴医院药学科研项目(Q2018063)。
关键词
肺疾病
慢性阻塞性
投药
吸入
药学服务
Pulmonary disease,chronic obstructive
Administration,inhalation
Pharmaceutical services
