以目标为导向的药学营养服务体系在腹膜透析肾性贫血患者中的成效分析  

Effectiveness analysis of goal-oriented pharmaceutical-nutrition care model for renal anemia in peritoneal dialysis patients

作　　者：李璐璐[1] 杨香瑜[1] 丁艳琼[2] 罗庆[2] 万胜[2] 张燕敏[2] LI Lu-lu;YANG Xiang-yu;DING Yan-qiong;LUO Qing;WAN Sheng;ZHANG Yan-min(Department of Pharmacy,Wuhan No.1 Hospital,Hubei Wuhan 430022,China;Department of Nephropathy,Wuhan No.1 Hospital,Hubei Wuhan 430022,China)

机构地区：[1]武汉市第一医院,药学部,湖北武汉430022 [2]武汉市第一医院,肾病内科,湖北武汉430022

出　　处：《中国医院药学杂志》2023年第9期995-1001,共7页Chinese Journal of Hospital Pharmacy

基　　金：湖北省临床药学重点专科(鄂卫通[2019]49号);武汉市卫生健康委员会武汉市医学科研资助项目(编号:WX19C22)。

摘　　要：目的:探讨基于目标为导向的药学营养服务体系在腹膜透析肾性贫血患者中的应用效果。方法:回顾性分析腹膜透析肾性贫血患者药学营养控制难点,建立以目标为导向的药学门诊服务模式,包括药学评估、营养评估、个体化宣教、随访指导等药物治疗管理。选取2021年7月至2022年6月腹透药学营养门诊收治的132例肾性贫血患者为研究对象,于管理后1月进行随访,利用疾病管理指标、药学管理指标、人文管理指标评估药物治疗管理的实施效果。结果:通过制定腹膜透析肾性贫血患者以目标为导向的药学营养服务体系,进一步规范药学门诊工作。药学营养服务前后,患者血红蛋白水平分别为(90±11) g·L^(-1)和(101±19) g·L^(-1),差异具有统计学意义(P<0.01);白蛋白水平分别为(31.7±6.1) g·L^(-1)和(32.9±7.0) g·L^(-1),差异具有统计学意义(P<0.01);药物与营养相关问题分别为276例和81例,用药依从性差由71.2%下降至23.5%,满意度分别为80.3%和93.9%。结论:将目标为导向的药学营养服务体系应用于门诊腹膜透析患者中,可有效提高肾性贫血达标情况,降低用药风险,提升药学服务质量,为慢病患者药学门诊的工作提供新的思路。OBJECTIVE To explore the effectiveness of goal-oriented pharmaceutical-nutrition care model for renal anemia in peritoneal dialysis patients.METHODS A retrospective study was conducted on the pharmaceutical-nutrition controlling difficulties in peritoneal dialysis patients with renal anemia.The working mode of goal-oriented pharmacy services was established,including pharmaceutical evaluation,nutritional assessment,personalized education and follow-up guidance.A total of 132 renal anemia patients in peritoneal dialysis pharmaceutical-nutrition clinic from July 2021 to June 2022 were selected as the research objects.Follow-up was conducted after the first month of management.The implementation effects of drug treatment management were evaluated by using the disease management indicators,pharmaceutical management indicators and human management indicators.RESULTS Through the development of goal-oriented pharmacy services pathway,the pharmacy services were more normative in pharmaceutical clinic.The study showed that the hemoglobin levels of the patients before and after intervention were(90±11)g·L-1 and(101±19)g·L-1,respectively,and there was significant difference(P<0.01).The albumin levels of the patients before and after intervention were(31.7±6.1)g·L-1 and(32.9±7.0)g·L-1,respectively,and there was significant difference(P<0.01).Drug-and nutrition-related problems before and after intervention were 276 and 81,respectively.Furthermore,poor medication compliance decreased from 71.2%to 23.5%,and satisfaction was 80.3%and 93.9%,respectively.CONCLUSION The goal-oriented pharmaceutical-nutrition care model in peritoneal dialysis outpatients can effectively improve renal anemia control,reduce the risk of medication,improve the quality of pharmaceutical care,and provide new ideas for the development of pharmaceutical clinic.

关 键 词：药学服务 药学门诊 腹膜透析 肾性贫血 

分 类 号：R969.3[医药卫生—药理学]