摘要
目的 对门诊就诊的卒中合并高血压的患者建立基于药物治疗管理(MTM)理念的药学服务模式,并考察这种模式在改善患者临床结局等方面的效果。方法 依据MTM药学服务方法的5个部分,融合进卒中合并高血压的患者的特定监护内容和流程,建立相应的药学服务模式。按照纳入与排除标准,收集于2021年8月至10月在上海市浦东医院神经内科门诊就诊的卒中合并高血压患者,随机分为干预组与对照组。干预组患者在入组3个月内接受基于MTM理念药学监护;对照组患者研究期间无特殊干预。两组患者都在研究开始与结束时接受Morisky、NIHSS、mRS、Barthel以及血压达标率评估,并使用欧洲药学监护联盟(PCNE)药物相关问题(DRPs)分类系统(V9.0)记录DRPs。结果 依据MTM方法,构建了适合卒中合并高血压的患者的药学服务模式。经过系统的药学监护,最后一次随访时,干预组患者Morisky(7.59±0.66)、NIHSS(2.29±2.21)、mRS(1.25±1.09)、Barthel评分(90.12±15.40)以及血压达标率(84.14%)均优于对照组患者的Morisky(6.99±1.58)、NIHSS(3.18±2.68)、mRS(1.67±1.35)、Barthel评分(83.33±15.92)以及血压达标率(65.56%)(P<0.05);DRPs发生情况干预组也优于对照组(32个比63个,P<0.05)。结论 构建的卒中合并高血压的患者的药学服务模式,对患者进行系统而全面的用药监护能够改善门诊卒中合并高血压患者的相关临床结局和DRPs发生情况。
Objective To establish a pharmaceutical care model based on the concept of drug therapy management(MTM)for outpatients with stroke and hypertension,and to investigate the effect of this model in improving the clinical outcomes of patients. Methods In accordance with the five parts of MTM pharmaceutical care method,the specific monitoring content and process of stroke patients with hypertension were integrated,and the corresponding pharmaceutical care model was established. According to the inclusion and exclusion criteria,stroke patients with hypertension who visited the neurology outpatient department of Shanghai Pudong Hospital from August to October 2021 were collected and randomly divided into the intervention group and the control group. Patients in the intervention group received pharmaceutical care based on MTM concept within 3 months after enrollment. There was no special intervention in the control group. Patients in both groups received Morisky,NIHSS,mRS,Barthel,and blood pressure compliance assessments at the beginning and the end of the study,and DRPs were recorded using the Pharmaceutical Care Network Europe(PCNE) Drug-Related Problems(DRPs) Classification System(V9. 0). Results According to the MTM method,a pharmaceutical care model suitable for stroke patients with hypertension was constructed. After systematic pharmaceutical care,the Morisky score 7. 59±0. 66,NIHSS score 2. 29±2. 21,mRS score 1. 25±1. 09,Barthel score 90. 12±15. 40 and blood pressure compliance rate(84. 14%) in the intervention group(n=82) were significantly(P<0. 05) better than those in the control group(n = 90)(Morisky score 6. 99±1. 58;NIHSS score3. 18±2. 68;mRS score 1. 67±1. 35;Barthel score 83. 33±15. 92;blood pressure compliance rate,65. 56%) at the last visit.The incidence of DRPs in the intervention group was also better than that in the control group(32 vs. 63,P<0. 05).Conclusion Based on the constructed pharmaceutical care model suitable for patients with stroke and hypertension,systematic and comprehensive medi
作者
龚婧如
严天浩
杨涛
陆惠平
GONG Jing-ru;YAN Tian-hao;YANG Tao;LU Hui-ping(Department of Pharmacy,Shanghai Pudong Hospital,Shanghai 201399,China)
出处
《临床药物治疗杂志》
2022年第10期49-53,共5页
Clinical Medication Journal
基金
上海市浦东新区卫生系统医学人才培养计划(PWRd2017-11)
上海市“医苑新星”青年医学人才培养资助计划(沪卫人事[2020]87号)
上海市浦东医院院级人才培养计划(PX201904)。
