房颤患者门诊抗凝用药管理与实践  

Management and practice of anticoagulant drugs in outpatients with atrial fibrillation

作　　者：陆红柳[1] 张楠[1] 闫阔 蔡泓敏[1] 杨啸白[1] 李桃园[1] 夏文斌[1] LU Hong-liu;ZHANG Nan;YAN Kuo;CAI Hong-min;YANG Xiao-bai;LI Tao-yuan;XIA Wen-bin(Department of Pharmacy,Beijing Chui Yang Liu Hospital,Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院药剂科,北京100022

出　　处：《临床药物治疗杂志》2020年第8期70-74,共5页Clinical Medication Journal

基　　金：首都临床特色应用研究(项目编号:Z181100001718125);北京市朝阳区社会发展计划(项目编号:CYSF1944);首都卫生发展科研专项(项目编号:首发2011-7021-02)。

摘　　要：目的为优化房颤患者抗凝治疗效果、防范用药风险,探讨建立药学门诊用药管理服务模式并评价服务效果。方法建立药学门诊房颤患者抗凝治疗服务管理模式,通过分析北京市垂杨柳医院2019年1-12月药学门诊131名抗凝患者就诊信息,建立药学服务管理档案,评估首诊患者用药依从性和疾病控制情况,分类分析抗凝治疗中存在的问题,并有针对性地开展个体化用药教育、干预和监护管理。随访3个月后对患者再评估,并对患者依从性、疾病控制情况等方面进行考察。结果患者首次评估后发现75条抗凝治疗相关问题,随访3个月后干预解决70条,干预有效率为93.3%;患者首诊时依从性评估平均分为(5.38±2.83)分,3个月后平均分为(6.66±2.15)分,依从性改善显著(P<0.05);且患者的病情控制情况较3个月前也有明显改善,总改善率为85.0%。结论药学门诊对房颤患者的服务管理,可以帮助抗凝患者尽早发现问题、解决问题,从而有效降低治疗风险、优化治疗效果,提高患者依从性。Objective This study was designed to optimize the effect of anticoagulant treatment and prevent the risk of medication,establish anticoagulant pharmaceutical care model in patients with atrial fibrillation in our hospital and evaluate the effect of anticoagulant pharmaceutical care.Methods In anticoagulation clinic by pharmacist,a management model was established for 131 patients with atrial fibrillation,and patients’information was recorded and analyzed,the adherence and disease control were assessed to classify the existing problems and carry out individualized drug education,intervention and monitoring management.After 3 months of follow-up,the patients were re-evaluated,and their adherence,disease control and other aspects were investigated.Results 75 problems related to anticoagulant therapy were found at the first evaluation.After 3 months of follow-up and intervention management,70 problems were solved by intervention with an effective rate of93.3%.The average score of compliance assessment at the first diagnosis was(5.38±2.83)cent,and the average score at 3 rd month was(6.66±2.15)cent.The patients’adherence was significantly improved(P<0.05).The comparative analysis on the patient’s condition control before and after pharmaceutical care management showed that the total improvement rate was85.0%.Conclusion The management of pharmacy clinic for patients with atrial fibrillation can help anticoagulation patients solve problems,reduce risks and improve compliance.

关 键 词：药学门诊 抗凝 房颤 风险评估 依从性 

分 类 号：R972[医药卫生—药品]