循证药学服务对临床药师在非瓣膜性房颤患者利伐沙班抗凝治疗中的应用价值  

Application value of evidence-based pharmacy service to clinical pharmacists in rivaroxaban anticoagulation therapy in patients with non-valvular atrial fibrillation

作　　者：孙洁[1] 陈国梅[1] 黄吉 SUN Jie;CHEN Guomei;HUANG Ji(Taicang First People′s Hospital/Taicang Hospital Affiliated to Soochow University,Jiangsu Province,Taicang 215400,China)

机构地区：[1]江苏省太仓市第一人民医院/苏州大学附属太仓医院,215400

出　　处：《临床合理用药杂志》2022年第25期1-4,8,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：苏州市科技发展计划(民生科技—医疗卫生应用基础研究)项目(SYSD2018224)。

摘　　要：目的观察循证药学对临床药师在非瓣膜性房颤患者利伐沙班治疗中的应用价值,为改进药学服务模式提供参考。方法选取2018年7月—2019年6月江苏省太仓市第一人民医院/苏州大学附属太仓医院收治的口服利伐沙班抗凝治疗的非瓣膜性房颤患者200例,依据随机数字表法分为研究组和对照组,每组100例。研究组采用循证药学服务模式,对照组采用普通药学服务模式。比较2组干预后终点事件、再入院次数,干预前后检验指标。结果研究组患者栓塞事件及出血事件总发生率均低于对照组(P<0.05),但各子类别发生率比较差异均无统计学意义(P>0.05);随访1年,2组患者再入院次数比较差异无统计学意义(P>0.05);干预前后2组患者血红蛋白、血小板计数、凝血酶原时间、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血肌酐水平比较差异均无统计学意义(P>0.05)。结论基于循证药学的药学服务模式更能提高患者用药的安全性和有效性,而对患者再入院次数、血红蛋白、血小板计数、凝血酶原时间及肝肾功能等指标的影响有待进一步研究。Objective To observe the application value of evidence-based pharmacy to clinical pharmacists in the treatment of rivaroxaban in patients with non-valvular atrial fibrillation,so as to provide reference for improving the pharmacy service model.Methods A total of 200 patients with non-valvular atrial fibrillation who were treated with oral rivaroxaban anticoagulation from July 2018 to June 2019 in Taicang First People′s Hospital/Taicang Hospital Affiliated to Soochow University were selected.According to the random number table method,they were divided into study group and control group,with 100 cases in each group.The study group adopted the evidence-based pharmacy service model,and the control group adopted the general pharmacy service model.The post-intervention endpoint events,the number of readmissions,and the test indicators before and after the intervention were compared between the two groups.Results The total incidences of embolic events and bleeding events in the study group were lower than those in the control group(P<0.05),but there were no significant difference in the incidence of each subcategory(P>0.05);After 1 year of follow-up,there was no significant difference in the number of readmissions between the two groups(P>0.05);There were no significant difference in the levels of hemoglobin,platelet count,prothrombin time,alanine aminotransferase,aspartate aminotransferase and serum creatinine between the two groups before and after the intervention(P>0.05).Conclusion The drug service model based on evidencebased pharmacy can improve the safety and effectiveness of patients′medication,while the impact on the number of hospital admissions,hemoglobin,platelet count,prothrombin time,and liver and kidney function needs to be further studied.

关 键 词：非瓣膜性房颤 利伐沙班 循证药学 临床药师 

分 类 号：R969.3[医药卫生—药理学]