基于循证药学对利伐沙班用于非瓣膜性心房颤动的全程管理效果评价  

Evaluation of the Effectiveness of the Whole-process Management Based on Evidence-Based Pharmacy for Non-Valvular Atrial Fibrillation Using Rivaroxaban

作　　者：陈国梅[1] 孙洁[1] 陈蓉[2] CHEN Guomei;SUN Jie;CHEN Rong(Department of Pharmacy,First People's Hospital of Taicang City(Taicang Hospital Affiliated to Soochow University),Taicang 215400,China;Department of Pharmacy,the First Affiliated Hospital of Soochow University,Suzhou 215006,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)药剂科,太仓215400 [2]苏州大学附属第一医院药学部,苏州215006

出　　处：《医药导报》2023年第10期1566-1571,共6页Herald of Medicine

基　　金：苏州市科技局科研项目(SYSD2018224)。

摘　　要：目的观察临床药师基于循证药学(EBP)对使用利伐沙班的非瓣膜性心房颤动(房颤)患者的全程管理效果,为改进药学服务模式提供参考。方法选取某院2018年7月—2019年6月诊断为非瓣膜性房颤且口服利伐沙班的住院患者270例作为研究对象,随机分为对照组和干预组,各135例,分别采用常规诊疗服务和基于EBP的全程管理模式,对比两组干预后栓塞及出血事件发生率,并通过成本-效益分析法对其经济性进行评价。结果干预期间,对照组13例、干预组7例患者因经济原因退出试验。干预后两组患者栓塞和出血事件均差异有统计学意义(P<0.05)。经济学评价结果显示,与对照组比较,干预组人均成本增加112.58元,降低的医保支付费用为1098.01元,效益-成本比为9.75,具有经济性。敏感度分析支持成本-效益分析结果。结论与常规诊疗服务模式相比,基于EBP的全程管理在有效性和安全性提高的同时,也具有一定的经济学价值。Objective To observe the effect of evidence-based pharmacy(EBP)on the whole-process management for the patients with non-valvular atrial fibrillation using rivaroxaban by clinical pharmacists,and to provide a reference for improving pharmaceutical care mode.Methods A total of 270 inpatients diagnosed with non-valvular atrial fibrillation and treated with oral rivaroxaban in a hospital from July 2018 to June 2019 were selected as subjects,and randomly divided into control group(135 cases)and intervention group(135 cases).Patients in the control group received conventional clinical diagnosis and treatment,while clinical pharmacists managed the intervention group patients based on EBP mode.The incidence of embolic events and bleeding events were compared between the two groups,and the economics were evaluated through cost-benefit analysis method.Results During the intervention period,13 patients in the control group and seven patients in the intervention group withdrew from the trial for financial reasons.The difference of embolic events and bleeding events after intervention between the two groups was statistically significant(P<0.05).The results of economic evaluation showed that compared with the control group,the per capita cost of the intervention group increased by 112.58 yuan,and the reduced medical insurance payment cost was 1098.01 yuan,with the benefit-cost ratio of 9.75,which was economical.The results of cost-benefit analysis were supported by sensitivity analysis.Conclusion Compared with the conventional clinical diagnosis and treatment service mode,the evidence-based pharmacy on the whole-process management for the patients could improve the effectiveness and safety,and show the economic value.

关 键 词：利伐沙班 循证药学 非瓣膜性心房颤动 全程管理 评价分析 

分 类 号：R973.2[医药卫生—药品]