药师主导的间歇性血液透析患者药物治疗管理模式的建立与实践  

Establishment and Practice of Medication Therapy Management Mode for Intermittent Hemodialysis Patients Led by Pharmacists

作　　者：李亚南[1] 肖芝梅 骆臣 丁晨慧 马晓喻 沈锦华[1] LI Yanan;XIAO Zhimei;LUO Chen;DING Chenhui;MA Xiaoyu;SHEN Jinhua(Department of Pharmacy,Rugao People's Hospital,Rugao,Jiangsu 226500,China;Department of Rheumatology and Immunology,Rugao People's Hospital,Rugao,Jiangsu 226500,China)

机构地区：[1]如皋市人民医院药剂科,如皋226500 [2]如皋市人民医院肾脏风湿免疫科,如皋226500

出　　处：《药学与临床研究》2021年第2期135-139,共5页Pharmaceutical and Clinical Research

基　　金：南通市市级科技计划(指导性)项目(MSZ19085)。

摘　　要：目的:探索间歇性血液透析患者药物治疗管理(medication therapy management,MTM)的模式。方法:以本院肾脏风湿免疫科间歇性血液透析的慢性肾功能不全(尿毒症期)患者为研究对象,收集患者200例,随机分为对照组和MTM干预组、各100例。将两组患者在院期间、出院后1月、3月、6月的临床检测指标、用药依从性、是否发生不良反应等进行比较,查验MTM实施成效。结果:经MTM后,在干预组临床指标中,Hb均显著高于对照组,HR和钙磷代谢达标率在出院后3个月、6个月与对照组有差异,BUN和SCr与对照组比较相差不大。干预组用药不适宜占比、不良反应发生率、6个月内再入院率均有效降低,血压达标率、血糖达标率、出院6个月后用药依从性评分均显著提升。结论:通过对间歇性血液透析患者实施MTM,为患者用药的有效性和安全性提供了保障,也为药师的临床工作模式提供了新思路。Objective:To explore the mode of medical therapy management(MTM)for intermittent hemodialysis patients.Methods:Two hundred patients with chronic renal insufficiency(uremic stage)were randomly divided into control and MTM intervention groups.The clinical test indexes,drug compliance and incidence of serious medical events between the two groups were compared in hospital and 1,3 and 6 months after discharge to check the effects of MTM implementation.Results:Hb levels in the intervention group after MTM were significantly higher than those in the control group.The HR and calcium phosphorus metabolic rates of the intervention group were different from those of the control group at 3 and 6 months after discharge,while BUN and SCr levels were not significantly different between the two groups.In the intervention group,the proportion of inappropriate drugs,the incidence of adverse reactions and the rate of readmission within six months were effectively reduced,and the rates of blood pressure and blood glucose reaching the standards and the scores of drug compliance after six months of discharge were significantly increased.Conclusions:The implementation of MTM for intermittent hemodialysis patients guarantees the effectiveness and safety of drug use for patients,and also provides a new idea for pharmacists'clinical work mode.

关 键 词：间歇性血液透析 药师 药物治疗管理 

分 类 号：R969[医药卫生—药理学] R969.3[医药卫生—药学]