临床药师参与长期服用华法林抗凝治疗的药学服务实践  

Pharmacy services practice of clinical pharmacists participate in long-term warfarin anticoagulation therapy

作　　者：汪姗 熊光宗[1] 蔡红专[2] WANG Shan;XIONG Guangzong;CAI Hongzhuan(Department of Pharmacy,People′s Hospital of Macheng City,Hubei Province,Macheng 438300,China;不详)

机构地区：[1]湖北省麻城市人民医院药剂科,438300 [2]湖北省麻城市人民医院心内科,438300

出　　处：《临床合理用药杂志》2022年第23期24-26,37,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：武汉市第四医院·麻城市人民医院科技人才培育专项科研基金项目(KY-Y-201807)。

摘　　要：目的观察临床药师在长期服用华法林患者抗凝管理中的作用。方法选择2020年3月—2021年1月湖北省麻城市人民医院心内科收治的长期应用华法林抗凝治疗的住院患者40例,采用随机数字表法分为干预组和对照组各20例。对照组接受常规医疗方案,干预组在对照组治疗方案的基础上,药师对入组患者进行医嘱审核、药学监护、用药教育及出院随访。比较2组患者抗凝认知水平、国际标准化比值(INR)达标率及用药安全性。结果出院后3个月,干预组患者用药知识评估总分高于干预前和对照组(P<0.01),对照组干预前后比较差异无统计学意义(P>0.05);干预组INR在目标范围内的时间百分比(TTR)为35.48%(22/62),高于对照组的20.37%(11/54),差异有统计学意义(χ^(2)=5.643,P=0.018);干预组出血事件发生率为5.00%,低于对照组的30.00%,差异有统计学意义(χ^(2)=4.329,P=0.037)。结论临床药师参与华法林抗凝治疗的抗凝管理可显著提高患者的INR达标率和抗凝认知水平,降低不良事件的发生率。Objective To observe the role of clinical pharmacists in the management of anticoagulation in patients taking long-term warfarin.Methods A total of 40 inpatients with long-term warfarin anticoagulation who were admitted to the Department of Cardiology,People′s Hospital of Macheng City in Hubei Province from March 2020 to January 2021 were selected.They were divided into intervention group and control group with 20 cases in each group by random number table method.The control group received routine medical treatment,while the intervention group received medical advice,pharmaceutical care,medication education and discharge follow-up by pharmacists on the basis of the treatment plan of the control group.The anticoagulation cognitive level,international normalized ratio(INR)compliance rate and drug safety were compared between the two groups.Results Three months after discharge,the total score of medication knowledge assessment in the intervention group was higher than that before the intervention and the control group(P<0.01),there was no significant difference between three months after discharge and before intervention in the control group(P>0.05);The time percentage(TTR)of INR within the target range in the intervention group was 35.48%(22/62),which was higher than 20.37%(11/54)in the control group,and the difference was statistically significant(χ^(2)=5.643,P=0.018);The incidence of bleeding events in the intervention group was 5.00%,which was lower than 30.00%in the control group,and the difference was statistically significant(χ^(2)=4.329,P=0.037).Conclusion The participation of clinical pharmacists in the anticoagulation management of patients treated with warfarin anticoagulation can significantly improve the patients′INR compliance rate and anticoagulation cognition level,and reduce the incidence of adverse events.

关 键 词：临床药师 华法林 抗凝治疗 药学服务 

分 类 号：R969[医药卫生—药理学]