药物治疗管理服务对2型糖尿病肾病患者的干预效果评价  

Intervention Effects of Medication Therapy Management Service on Patients with Type 2 Diabetic Nephropathy

作　　者：刘燕[1] 肖勇 战蕾 朱艳 熊国营 虞佳[1] LIU Yan;XIAO Yong;ZHAN Lei;ZHU Yan;XIONG Guoying;YU Jia(The First Hospital of Nanchang,Nanchang Jiangxi 330008,China;The Second Affiliated Hospital of Nanchang University,Nanchang Jiangxi 330006,China)

机构地区：[1]南昌市第一医院,江西南昌330008 [2]南昌大学第二附属医院,江西南昌330006

出　　处：《药品评价》2023年第3期342-347,共6页Drug Evaluation

基　　金：江西省卫生健康委科技计划项目(20204020);江西省药品监督管理局科研项目(2021KY17)。

摘　　要：目的分析临床药师药物治疗管理服务模式在2型糖尿病肾病患者管理中的应用效果。方法2020年1月至2020年12月收治2型糖尿病肾病患者47例,随机分为观察组(n=25)和对照组(n=22),对照组给予常规药学管理,观察组在对照组基础上增加由临床药师基于药物治疗管理(MTM)模式进行的药学服务,对两组患者随访12个月。结果观察组干预前后发现药物相关问题分别为83和40项。干预后,观察组患者血糖控制(空腹血糖、餐后1 h及餐后2 h血糖、糖化血红蛋白),血脂(胆固醇、低密度脂蛋白),肾功能(血肌酐、肌酐清除率)改善明显优于对照组(P=0.024,0.032,0.002,0.023,0.002,0.002,0.021,0.032);疾病认知、用药依从性及糖尿病自我管理评估得分均显著高于对照组(P=0.003,0.007,0.029)。结论临床药师基于MTM模式的药学服务有助于提高2型糖尿病肾病患者的疾病认知度,用药依从性及自我管理水平,并有效控制血糖水平和全身疾病症状,延缓糖尿病肾病进展。Objective To evaluate the intervention effect of medication therapy management(MTM)service mode based on pharmacists'participation in the management of patients with type 2 diabetic nephropathy.Methods From January 2020 to December 2020,47 patients with type 2 diabetic nephropathy were enrolled and randomly divided into the observation group(n=25)and the control group(n=22).The control group was given conventional pharmaceutical management,while the observation group was given pharmaceutical management based on MTM model by clinical pharmacists on the basis of the conventional management in control group.Two groups of patients were followed up for 12 months.Results The observation group,83 and 40 drug-related problems were found before and after intervention.After the intervention,the control of blood glucose(fasting plasma glucose,1 h and 2 h postprandial blood glucose,glycosylated hemoglobin),blood lipid(cholesterol,low density lipoprotein),renal function(serum creatinine,creatinine clearance)in observation group improved significantly better than control group(P=0.024,0.032,0.002,0.023,0.002,0.002,0.021,0.032),the scores of disease cognition,medication compliance and diabetes self-management assessment in observation group were significantly higher than those of the control group(P=0.003,0.007,0.029).Conclusion The pharmaceutical care based on MTM model by clinical pharmacists can help improve the disease cognition,medication compliance and self-management level,and effectively control blood glucose level and systemic disease symptoms,and delay the progression of disease in patients with type 2 diabetic nephropathy.

关 键 词：药物治疗管理 药学服务 临床药师 2型糖尿病肾病 效果评价 

分 类 号：R95[医药卫生—药学]