交互式用药指导在老年冠心病合并2型糖尿病门诊患者中的效果及影响  

Efficacy and Influence of Medical Education by Pharmacist-Patient Consultation Program in Elderly Outpatients with Coronary Heart Disease and Type Ⅱ Diabetes

作　　者：谈震 潘晓东[2] 殷钢 傅坤发[2] 王振山[1] 王怡[1] 张明淋 蒋萍 曲国红 侯任婕 Tan Zhen;Pan Xiaodong;Yin Gang;Fu Kunfa;Wang Zhenshan;Wang Yi;Zhang Minglin;Jiang Ping;Qu Guohong;Hou Renjie(Department of Pharmacy,Jiangsu Provincial Geriatric Hospital/Jiangsu Provincial Official Hospital,Nanjing 210024,China;Department of Geratology,Jiangsu Provincial Geriatric Hospital/Jiangsu Provincial Official Hospital;Department of Pharmacy,No.454 Hospital of the PLA)

机构地区：[1]江苏省老年医院/江苏省省级机关医院老年药学研究室,南京210024 [2]江苏省老年医院/江苏省省级机关医院老年医学科 [3]解放军第454医院药学部

出　　处：《中国药师》2018年第11期1996-1999,共4页China Pharmacist

基　　金：江苏省药学会--奥赛康医院药学科研项目(编号:A201625)

摘　　要：目的:探讨临床药师参与老年心血管病联合门诊的药学服务效果。方法:选取我院老年心血管病联合门诊合并冠心病与2型糖尿病的患者182例,随机分成对照组(n=94)和干预组(n=88)。临床药师对对照组进行常规用药指导,对干预组进行交互式用药指导,每月随访1次。随访3个月后,比较两组患者接受用药指导后的药师信任度、用药回忆度、用药依从性,以及糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)等生化指标变化及HbA1c和LDL-C达标率。结果:接受用药指导后,干预组药师信任度、用药回忆度、用药依从性等指标得分均优于对照组(P <0. 05);随访3个月后,干预组HbA1c水平及达标率较对照组更优(P <0. 05),两组LDL-C、ALT、AST水平等指标及LDL-C达标率比较,差异无统计学意义(P> 0. 05)。结论:临床药师应用交互式用药指导为老年患者提供药学服务,显著提高患者对药师的信任度、用药回忆度、用药依从性和血糖达标率。Objective ： To explore the effects of pharmaceutical care mode for clinical pharmacists in participating in the geriatric CVD joint clinic. Methods： Totally 182 geriatric patients with cardiovascular disease were randomly assigned into the control group （n = 94） and the intervention group （ n = 88 ）. The clinical pharmacist guided the intervention group with pharmacist-patient consultation program, while the control group only received the routine guidance. The patients were given follow-up visits once every month. After 3-month follow-up, the conditions of the two groups were analyzed including the trust to pharmacists, drug-information recall, medication scheme compliance, the changes in such biochemical indices as HbAlc, LDL-C, alanine aminotransferase （ALT） and aspartate aminotransferase （ AST）, and the reaching rate of HbA1c and LDL-C. Results： After receiving medication guidance, the trust to pharmacists, drug-information recall and medication scheme compliance in the intervention group were significantly better than those in the control group（P 〈 0.05） ; after the 3-month follow-up, HbA1c and its reaching rate in the intervention group was significantly better than that in the control group（P 〈 0.05 ） ; however, there were no significant differences in LDL-C, ALT, AST and the reaching rate of LDL-C between the groups （ P 〉 0.05 ）. Conclusion ： Clinical pharmacist provides pharmaceutical care for the elderly patients with pharmacist-patient consultation program, which can significantly improve the trust to pharmacists, drug-information recall, medication scheme compliance and the index of blood glucose.

关 键 词：交互式用药指导 临床药师 联合门诊 冠心病 2型糖尿病 

分 类 号：R97[医药卫生—药品]