基于医联体的COPD社区医药协作联盟模式探索  

Exploration of COPD Community Pharmacist-led Medical Cooperative Alliance Model Based on Medical Alliance

作　　者：蒙晓[1] 何素珍[1] 刘亮辉[1] 陈璐[1] 叶枫[2] 李征途[2] 魏理[1] MENG Xiao;HE Suzhen;LIU Lianghui;CHEN Lu;YE Feng;LI Zhengtu;WEI Li(The First Affiliated Hospital of Guangzhou Medical University Department of Pharmacy,Guangzhou,Guangdong 510120,China;The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease,National Clinical Research Center for Respiratory Disease,Guangzhou Institute of Respiratory Health,Guangzhou,Guangdong 510120,China)

机构地区：[1]广州医科大学附属第一医院药学部,广东广州510120 [2]广州医科大学附属第一医院广州呼吸健康研究院,呼吸疾病国家重点实验室,国家呼吸系统疾病临床医学研究中心,广东广州510120

出　　处：《今日药学》2020年第3期197-200,共4页Pharmacy Today

基　　金：广东省医院药学研究基金(2020A36)。

摘　　要：目的构建以药师为主导的慢性阻塞性肺疾病(COPD)社区医药协作联盟,通过学科协作,改善区域内COPD患者诊、治、防、管上下分离的问题,推动分级诊疗实施。方法我院与广州市白云区同德围街社区卫生服务中心合作试点,以医药协作门诊为工作核心,专科药品衔接工作为切入点,社区药事管理帮扶、家庭药师和健康宣教工作为辅助,构建以药师为主导的COPD社区医药协作联盟。结果2019年1~6月期间本项目落实情况如下:(1)COPD社区医药协作门诊开诊16次,肺功能筛查176人,落实向上转诊患者12人;(2)通过专科药品衔接工作社区呼吸系统药物新增13个品规,社区呼吸系统治疗药物品规数与我院的衔接度增幅达10.71%,增补后社区药物可覆盖COPD急性加重期与稳定期治疗;(3)社区药事管理工作进一步完善,处方点评合理率提升12.38%;(4)签约家庭药师8人,提供上门/电话随访药学服务次数38次;(5)举办社区健康宣教2场。结论以药师为主导的COPD社区医药协作联盟在一定程度上可改善COPD患者诊、治、防、管过程中上下分离的问题,并推动区域内分级诊疗实施。OBJECTIVE To establish a community pharmacist-led medical collaboration alliance for chronic obstructive pulmonary disease(COPD),and improve the status of the separation of diagnosis,treatment,prevention and management of COPD patients in community hospitals and public hospitals,and promote the implementation of hierarchical diagnosis and treatment.METHODS Our hospital cooperated with the Tongdewei district health service center in Baiyun district,Guangzhou city to carry out a pilot project.With the medical collaboration clinic as the core of work and the drug catalog connection of respiratory drugs as the breakthrough point,community pharmacy management assistance and family pharmacists and health education work were assisted to establish the pharmacist-led COPD community medicine cooperation alliance.RESULTS The implementation of this project from January to June 2019 is as follows:(1)16 times community COPD collaborative outpatient clinics were serviced,176 patients were screened for pulmonary function,and 12 patients were transferred to our hospital;(2)13 respiratory medicines were added through drug connection work,10.71%increase of cohesion between community respiratory system drugs and our hospital,which can cover the acute exacerbation and stable phase treatment of COPD;(3)Community pharmacy management was further improved,and the reasonable rate of prescription reviews increased by 12.38%;(4)8 family pharmacists were contracted and 38 visits/telephone visits for pharmaceutical care were provided;(5)2 community health education were held.CONCLUSION The community pharmacist-led medical collaboration alliance can improve the separation of diagnosis,treatment,prevention and management of COPD patients in community hospitals and public hospitals,and promote the implementation of hierarchical diagnosis and treatment in the region.

关 键 词：分级诊疗 医联体 药学服务 慢性阻塞性肺疾病 

分 类 号：R95[医药卫生—药学]