药师干预对心脏瓣膜置换术后华法林治疗患者抗凝治疗管理的影响  

Effects of pharmacists’intervention on anticoagulant management of patients treated with warfarin after heart valve replacement

作　　者：向云霞[1] 蒲文[1] 李东锋[1] 王捷[1] XIANG Yunxia;PU Wen;LI Dongfeng;WANG Jie(Department of Pharmacy,the First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院药学部,新疆维吾尔自治区乌鲁木齐830054

出　　处：《中国药物警戒》2022年第5期545-549,共5页Chinese Journal of Pharmacovigilance

基　　金：2019年新疆维吾尔自治区药学会科研基金项目(YXH201916)。

摘　　要：目的评价药师开展药学服务对长期服用华法林治疗患者抗凝管理的影响及效果。方法对2018年5月1日至2019年12月31日经药师抗凝门诊就诊,符合纳入、排除标准并服用华法林抗凝治疗的226例心脏瓣膜置换术患者,按设定的药学服务流程进行随访管理,对比药学服务干预前后患者对华法林抗凝治疗的认知度和用药依从性,统计分析患者达标时间百分比(TTR)改善情况。结果患者接受药学服务干预后,对华法林用药知识的掌握情况及用药依从性显著提升,用药依从性高的患者数由19人(8.41%)增加到121人(53.54%),TTR从30.25%提高到63.65%(P<0.05)。结论药师参与长期服用华法林治疗的心脏瓣膜置换术患者抗凝管理,可显著提高抗凝治疗的有效性和安全性。Objective To evaluate the effects of pharmaceutical care on patients chronically taking warfarin and highlight the importance of clinical pharmacists.Methods A total of 226 patients who had undergone heart valve replacement and took warfarin as an anticoagulation treatment between May 2018 and December 2019 were enrolled according to the inclusion criteria.These patients were followed up according to the pharmaceutical service process.Their knowledge of the anticoagulation treatment with warfarin and medication compliance after pharmacist interventions were compared,and the improvement of time in therapeutic range(TTR)was analyzed.Results After interventions by pharmacists,the patients’knowledge of the use of warfarin and medication compliance were improved significantly.The number of patients with good medication compliance increased from 19(8.41%)to 121(53.54%),and the TTR increased from 30.25%to 63.65%(P<0.05).Conclusion Pharmacists’intervention in patients under long-term anticoagulation treatment with warfarin can improve the efficacy and safety of this therapy.

关 键 词：心脏瓣膜置换术 华法林 药师干预 抗凝治疗 安全性 

分 类 号：R96[医药卫生—药理学] R973.2[医药卫生—药学]