PCCM咳喘药学服务门诊互联网+智慧药学服务路径管理模式的构建与评价  

Establishment and Evaluation of the Internet+Intelligent Pharmaceutical Care Pathway Management Mode in the Pharmacist-managed Cough and Wheeze Clinic of PCCM

作　　者：郁件康 龚银华 郁文刘[1] 秦珺 陈蓉[1] 游一中[2] YU Jiankang;GONG Yinhua;YU Wenliu;QIN Jun;CHEN Rong;YOU Yizhong(Department of Pharmacy,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Clinical Pharmacy,the First People's Hospital of Changzhou,Changzhou 213003,China)

机构地区：[1]苏州大学附属第一医院药学部,苏州215006 [2]常州市第一人民医院药学部,常州213003

出　　处：《医药导报》2023年第8期1158-1165,共8页Herald of Medicine

基　　金：苏州市卫生青年骨干人才“全国导师制”项目(2021年);中国药学会施维雅青年医院药学创新研究资助项目(CPA-B04-ZC-2021-001);江苏省药学会医院药学科研项目(Q202118)。

摘　　要：目的构建呼吸与危重症医学(PCCM)咳喘药学服务门诊互联网+智慧药学服务路径管理的模式,评价其工作效果。方法选取2020年9月—2021年3月在苏州大学附属第一医院PCCM科门诊确诊的哮喘、慢性阻塞性肺疾病患者300例,随机分成对照组和干预组各150例。对照组进行常规药学服务;干预组纳入PCCM咳喘药学服务门诊互联网+智慧药学服务路径管理,包括患者信息建档与问诊、药学评估、药学干预(人工干预和智能干预)、用药教育、患者随访、互联网+药学服务。研究周期为6个月。分别于入组3、6个月对比两组患者吸入装置使用评分、用药依从性(MMAS-8)评分、临床有效控制率。入组6个月后对比两组患者急性发作/加重次数、药品不良反应发生率、药学服务满意度、药学门诊服务费支付意愿。结果入组3,6个月后,干预组患者吸入装置使用评分、用药依从性量表(MMAS-8)评分均显著高于入组时和同期对照组(P<0.05);临床有效控制率显著高于同期对照组(P<0.05)。入组6个月后,干预组患者急性发作/加重次数显著少于入组时和同期对照组(P<0.05),不良反应发生率减少了9.87%,工作质量和患者体验的满意度分别为91.83%,96.64%,愿意支付费用比例为67.12%。结论PCCM咳喘药学服务门诊互联网+智慧药学服务路径管理可为患者提供有效、安全、专业的药学服务,是规范化、同质化开展高质量药学服务的一次有益探索。Objective To construct the Internet+intelligent pharmaceutical care pathway management model in the Pharmacist-managed cough and wheeze clinic of pulmonary and critical care medicine(PCCM)and evaluate its work result.Methods A total of 300 patients with asthma and COPD diagnosed in the outpatient clinic of PCCM in the First Affiliated Hospital of Soochow University from September 2020 to March 2021 were selected,and randomly divided into a control group and intervention group with 150 cases in each group.The control group received routine pharmacy services;The intervention group was included in the Internet+intelligent pharmaceutical care pathway management in the pharmacist-managed cough and wheeze clinic of PCCM,including patient information filing and consultation,pharmacy evaluation,pharmacy intervention(human intervention and intelligent intervention),medication education,patient follow-up,Internet+pharmaceutical care.The study period was six months.The scores of inhalation device usage,medication compliance(MMAS-8),and clinical effective control rate were compared between the two groups in the third and sixth months after enrollment.After six months of enrollment,the number of acute attacks/exacerbations,incidence of adverse drug reactions,satisfaction with pharmacy services,and willingness to pay for the pharmaceutical care in the pharmacy clinic were compared between the two groups.Results At the third and sixth months after enrollment,the inhalation device usage score,and MMAS-8 score of the intervention group were significantly higher than those at the time of enrollment and the control group during the same period(P<0.05);The clinically effective control rate was significantly higher than the control group during the same period(P<0.05).After six months of enrollment,the number of acute attacks/exacerbations in the intervention group was significantly less than those at the time of enrollment,and in the control group during the same period(P<0.05),the incidence of adverse reactions was reduced by 9.87%

关 键 词：智慧药学 药学服务 互联网+ 路径管理 呼吸与重症医学 药学门诊 

分 类 号：R56[医药卫生—呼吸系统] R951[医药卫生—内科学]