药师主导的慢病管理对出院老年高血压患者血压影响的多中心随机对照试验  

Effect of pharmacist-led chronic disease management on blood pressure of discharged elderly patients with hypertension:a multicenter randomized controlled trial

作　　者：韩爽[1] 武丹威[1] 白颖[2] 张青霞[3] 施楠楠[1] 赵凯平[4] 张天婧 王继红[5] 张威[1] 甄健存[1] HAN Shuang;WU Dan-wei;BAI Ying;ZHANG Qing-xia;SHI Nan-nan;ZHAO Kai-ping;ZHANG Tian-jing;WANG Jihong;ZHANG Wei;ZHEN Jian-cun(Department of Pharmacy,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Pharmacy,Beijing Tongren Hospital,Capital Medical University,Beijing 100005,China;Department of Pharmacy,Xuanwu Hospital Capital Medical University,Beijing 100053,China;Department of Medical Record Management and Statistics,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Cardiology,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院药学部,北京100035 [2]首都医科大学附属北京同仁医院药学部,北京100005 [3]首都医科大学宣武医院药学部,北京100053 [4]北京积水潭医院病案统计科,北京100035 [5]北京积水潭医院心内科,北京100035

出　　处：《临床药物治疗杂志》2022年第5期38-42,共5页Clinical Medication Journal

基　　金：首都卫生发展科研专项项目(2016-2-2072)。

摘　　要：目的通过多中心、随机、对照试验,评价药师主导的慢病管理对出院老年高血压患者血压的影响。方法选择2016年1月至2018年4月期间北京积水潭医院、首都医科大学附属北京同仁医院、首都医科大学宣武医院符合标准的老年高血压住院患者,共303例入组,入院后进行同质化的药学服务,出院时将患者随机分为干预组(n=145)及对照组(n=158)。出院后药师对干预组患者进行药物重整、用药教育、用药咨询等药学服务,对照组不进行主动药学服务。分别在出院时、出院后3、6个月统计两组患者收缩压、舒张压及血压控制率情况。结果出院时两组患者的收缩压及舒张压差异无统计学意义(P=0.714,P=0.779),出院后3、6个月,两组的收缩压差异有统计学意义(P=0.021),舒张压差异无统计学意义(P=0.32);根据《中国高血压防治指南2010》及《中国高血压防治指南(2018年修订版)》,出院时两组患者的血压控制率差异无统计学意义(P=0.119,P=0.901),出院后3、6个月,干预组的血压控制率显著高于对照组(P=0.048,P=0.003)。结论药师主导的慢病管理可有效控制出院老年高血压患者的血压。Objective To evaluate the effect of pharmacist-led chronic disease management on blood pressure control in elderly discharged patients with hypertension in a multicenter,randomized,controlled trial.Methods A total of 303 elderly patients with hypertension who met eligibility the criteria were enrolled from Beijing Jishuitan Hospital,Beijing Tongren Hospital Affiliated to Capital Medical University and Xuanwu Hospital Capital Medical University from January 2016 to April 2018.After admission,the two groups of patients received homogeneous pharmaceutical care.At discharge,the patients were randomly divided into the intervention group(n=145)and control group(n=158).Pharmacists provided pharmaceutical care such as medication reconciliation,medication education and medication consultation to patients in the intervention group,while the control group did not receive active pharmaceutical care.Systolic blood pressure,diastolic blood pressure and blood pressure control rate of patients in the two groups were measured at discharge,3 and 6 months after discharge.Result There were no significant difference in systolic and diastolic blood pressure between the two groups at discharge(P=0.714,P=0.779).At 3 and 6 months after discharge,there was significant difference in systolic blood pressure between the two groups(P=0.021),while there was no significant difference in diastolic blood pressure(P=0.32).According to China’s Guidelines for the Prevention and Treatment of Hypertension 2010 and China’s Guidelines for the Prevention and Treatment of Hypertension(Revised in 2018),there was no significant difference in blood pressure control rate between the two groups at discharge(P=0.119,P=0.901).At 3 and 6 months after discharge,the blood pressure control rate of the intervention group was significantly higher than that of the control group(P=0.048,P=0.003).Conclusion Chronic disease management led by pharmacists can effectively control the blood pressure of discharged elderly patients with hypertension.

关 键 词：药师 慢病管理 老年 高血压 血压控制 

分 类 号：R95[医药卫生—药学] R972.4