慢性心力衰竭患者规范化用药干预效果研究  

Study on effects of standardized medication in patients with chronic heart failure

作　　者：胡安新[1] 徐冬梅[1] 周华[1] 邱波[1] 王同成[1] 

机构地区：[1]济南市第三人民医院,山东济南250132

出　　处：《中国医院药学杂志》2016年第6期498-502,共5页Chinese Journal of Hospital Pharmacy

基　　金：济南市科技局立项(编号:201121023)

摘　　要：目的：观察规范化用药干预对慢性心力衰竭患者的效果。方法：选取275例心功能Ⅱ～Ⅳ级的慢性心力衰竭患者作为研究对象,随机分为干预组140例和对照组135例。干预组患者分别于入院时、住院期间、出院前、出院后第1,2,3个月6个时点,经过评估—制定方案—干预—再评估循环,评价2组患者在出院3个月后的干预效果。结果：干预组与对照组患者对疾病知识和用药依从性提高明显高于对照组（P〈0.05）;干预组临床不合理用药情况改善显著好于对照组（P〈0.05）。血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂（ACEI/ARB）的使用率、达靶剂量率高于对照组（56.9%和29.2%;35.6%和16.4%,P〈0.05）,β受体阻滞剂使用率、达靶剂量率显著高于对照组（48.9%和29.2%,27.6%和16.4%,P〈0.05）,干预组较对照组患者用药依从性明显提高（干预组从来没有占95.7%～100%,对照组十分经常占31%～56%,P〈0.05）,干预组较对照组患者因心衰加重再入院率明显下降（16%和33%,P〈0.05）,2组死亡率无明显差异。结论：规范化用药干预能提高慢性心力衰竭患者有循证医学证据的药物治疗,提高患者用药依从性,降低再入院率。OBJECTIVE To investigate effects of standardized medication in patients with chronic heart failure.METHODS A total of 275 patients with chronic heart failure and cardiac functionⅡ-Ⅳ were randomized to intervention group（n=140）and control group（n=135）.Patients of intervention group were instructed by special clinical pharmacist verbally or by written materials at admission time,during hospitalization,before discharge,1,2 and 3 months after discharge for disease and drug knowledge to improve drug compliance and reduce irrational drug use.Standardized medication was improved through evaluation-plan development intervention-reevaluation cycles.Patients of control group were followed up by telephone 3 months after discharge.Patients of two groups were compared 3 months after discharge.RESULTS In intervention and control groups,patients＇ knowledge of disease（88.6%-90%,73.6%-90%,P〈0.05）,knowledge about treatment（92.9%-95.7%,57.9%-88.6%,P〈0.05）and medication adherence（95.7%-100%,31%-56%,P〈0.05）have improved significantly.Clinically irrational drug use improved significantly（1.4%-38.6%,1.4%-55%,P〈0.05）.Rates of patients taking ACEI/ARB and patients achieved targeted dose were higher in intervention group than in control group（56.9%vs.29.2%;35.6%vs.16.4%,P〈0.05）.Rates of patients taking beta-blockers and patients achieved targeted dose were higher in intervention group than in control group（48.9% vs.29.2%,27.6% vs.16.4%,P〈0.05）.Drug compliance of patients in the intervention group（95.7%-100% never forgot）was significantly improved than those in control group（31%-56% often forgot,P〈0.05）.Rate of rehospitalization of intervention group dramatically decreased compared to that of control group.There was no significant difference in mortality rate between two groups.CONCLUSION Standardized medication in patients with chronic heart failure can improve drug treatment of evidence-based medicine and compliance of patients,and decrease readmission rate.

关 键 词：慢性心力衰竭 规范化用药干预 效果 

分 类 号：R952[医药卫生—药学]