慢性呼吸系统疾病患者药学服务模式的构建  

Establishment of pharmaceutical care mode for patients with chronic respiratory diseases

作　　者：叶晓芬 金美玲[2] 张静[2] 杨延杰[2] 汤莉 金知萍 张捷青 李晓宇 吕迁洲 YE Xiaofen;JIN Meiling;ZHANG Jing;YANG Yanjie;TANG Li;JIN Zhiping;ZHANG Jieqing;LI Xiaoyu;LYU Qianzhou(Department of Pharmacy;Department of Pulmonary and Critical Care Medicine;Department of Nursing,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院药剂科,上海200032 [2]复旦大学附属中山医院呼吸与危重症医学科,上海200032 [3]复旦大学附属中山医院护理部,上海200032

出　　处：《上海医药》2022年第5期8-10,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:构建一种哮喘/慢性阻塞性肺疾病患者药学服务模式,以提高疾病控制率。方法:开设“呼吸药学门诊”和“吸入药物指导门诊”,线下重点对初次用药和用药操作方法错误的患者进行药学服务;线上拍摄并推广“吸入药物用药操作方法”科普视频,为患者提供最基础的吸入治疗药学服务;帮助医联体单位培训基层药师,提升他们的药学服务能力。结果:对呼吸药学门诊100例患者情况的分析发现,85.0%的患者有两个或以上药学相关问题待解决,其中涉及药品不良反应和药物相互作用的占比较大。对吸入药物指导门诊患者库中2305例哮喘/慢性阻塞性肺疾病患者情况的分析发现,首次使用吸入药物的患者占68.8%,用药操作方法错误或治疗依从性不佳的患者占31.2%。对479例吸入药物指导门诊患者进行吸气峰流速监测发现,在药学服务前,他们的吸气峰流速达标率仅为27.8%;药学服务后,达标率增高至93.1%。结论:药师全面参与慢性呼吸系统疾病药物治疗管理可提高疾病控制水平。Objective:To establish a pharmaceutical care mode for patients with chronic respiratory diseases and improve their disease control.Methods:Pharmacist-managed clinics(such as respiratory pharmacy clinics and inhaled drug education clinics)were opened to primarily educate patients with initial use of inhaled drugs or medication errors.The popular science video of“operation of inhalation drugs”online was made to provide patients with the most basic inhalation therapy pharmacy services.Collaboration with regional medical consortiums was performed to help primary pharmacists improve their pharmaceutical care capabilities.Results:Eighty-five percent of patients were found to have two or more pharmaceutical problems to be solved by analysis of 100 patients from respiratory pharmacy clinics,in which drug interactions and adverse reactions accounted for the largest proportion.An analysis of 2305 patients(all with asthma/chronic obstructive pulmonary disease)from inhaled drug education clinics indicated that 68.8%of them used inhaled drugs for the first time and 31.2%experienced medication errors or poor compliance.In addition,the measure of peak inspiratory flow rate in 479 patients revealed that their compliance rate was only 27.8%before the pharmaceutical care and could increase to 93.1%after that.Conclusion:Participation of pharmacists in drug treatment management of chronic respiratory diseases can improve disease control of the patients.

关 键 词：慢性呼吸系统疾病 药学服务模式 临床药师 

分 类 号：R197.1[医药卫生—卫生事业管理] R56[医药卫生—公共卫生与预防医学]