分级药学服务模式在系统性红斑狼疮患者中的实践  

Practice of Hierarchical Pharmaceutical Care Model in Patients with Systemic Lupus Erythematosus

作　　者：张春歌 吴憩[1] 魏巍[1] 韩强[1] 唐婕[1] 陈蓉[1] ZHANG Chun-ge;WU Qi;WEI Wei;HAN Qiang;TANG Jie;CHEN Rong(Department of Pharmacy,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院药学部,江苏苏州215000

出　　处：《中国药学杂志》2023年第6期537-543,共7页Chinese Pharmaceutical Journal

基　　金：苏州市科技局科研项目资助(SYSD2019177,SKJY2021057)。

摘　　要：目的探讨基于知信行干预理论(knowledge-attitude-practice,KAP)的分级药学服务模式在系统性红斑狼疮(systemic lupus erythematosus,SLE)患者中的实施效果。方法收集2019年1月~2022年2月在我院风湿免疫科门诊就诊并自愿参与研究的SLE患者,将符合纳入标准的530例患者随机分为对照组和干预组。对照组患者仅接受常规的用药交代,干预组患者依据分级药学服务标准接受不同级别的药学服务。对2组患者不同时间点的分级评分及KAP水平进行统计分析。干预9个月后,评价干预前后2组患者风险感知水平、疾病控制效果和预后情况。结果干预组患者KAP各维度在预设时间点的得分均低于对照组(P<0.05);9个月后,干预组较对照组一级和二级服务比例分别下降8.98%和5.38%,急性发作和不良反应发生率分别下降了12.88%和11.89%,风险感知水平、疾病活动度、器官损伤和临床检验指标均显著改善,差异具有统计学意义(P<0.05)。结论基于KAP干预理论为SLE患者提供分级药学服务,有利于药师快速筛选出需要重点干预的患者和采取针对性的干预措施,从而提高药学服务质量和疾病控制效果。OBJECTIVE To evaluate the implementation effect of hierarchical pharmaceutical care model based on the knowledge-attitude-practice(KAP)intervention theory in patients with systemic lupus erythematosus(SLE).METHODS SLE patients who received treatment at the rheumatology and immunology department from January 2019 to February 2022 and volunteered to participate in the study were collected,and 530 patients fulfilled the inclusion criteria were enrolled and randomly divided into intervention group and control group.The patients in the control group only received routine pharmaceutical care,while those in the intervention group were given different levels of pharmaceutical care according to the hierarchical pharmaceutical care criteria.The classification scores and KAP level of patients in the two groups at different time points were statistically analyzed.After 9 months of intervention,the risk perception level,disease control effect and prognosis of patients in the two groups before and after intervention were evaluated.RESULTS The scores of each dimension of KAP in the intervention group were lower than those in the control group at preset time points(P<0.05).After 9 months of intervention,compared with the control group,the proportions of first-level and second-level services in the intervention group reduced by 8.98%and 5.38%,respectively;the incidence rates of acute attack and adverse reaction was reduced by 12.88%and 11.89%,respectively;the risk perception level,disease activity,organ damage and clinical test indexes were all improved with statistical differences(P<0.05).CONCLUSION Providing SLE patients with pertinent hierarchical pharmaceutical care based on KAP intervention theory is beneficial for pharmacists to quickly screen out patients whom need to be focused on and adopt targeted intervention measures,so as to improve the quality of pharmaceutical care and the effect of disease control.

关 键 词：知信行 分级药学服务 系统性红斑狼疮 药学实践 效果评价 

分 类 号：R969.3[医药卫生—药理学]