连续性药学服务对鼻饲肠内营养食管癌患者用药相关问题和依从性的影响  

Effect of continuous pharmaceutical care on drug-related problems and compliance in esophageal cancer patients undergoing nasojejunal nutrition therapy

作　　者：李霄 包冲阳 李静凯 吴楠[4] Li Xiao;Bao Chongyang;Li Jingkai;Wu Nan(Department of Pharmacy,Xianyang First People′s Hospital,Xianyang 712000,China;Department of Urinary Surgery,Xianyang First People′s Hospital,Xianyang 712000,China;China Pharmaceutical University,Nanjing 210009,China;Jiangsu Cancer Hospital&Jiangsu Institution of Cancer Research&the Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]咸阳市第一人民医院药学部,陕西咸阳712000 [2]咸阳市第一人民医院泌尿外科,陕西咸阳712000 [3]中国药科大学药学院,江苏南京210009 [4]江苏省肿瘤医院&江苏省肿瘤防治研究所&南京医科大学附属肿瘤医院临床药学科,江苏南京210029

出　　处：《实用药物与临床》2023年第11期1000-1004,共5页Practical Pharmacy and Clinical Remedies

基　　金：江苏省药学会恒瑞医院药学基金立项课题(H202128)。

摘　　要：目的 探讨连续性药学服务对鼻饲肠内营养的食管癌患者用药相关问题和依从性的影响。方法 选取2022年4-9月江苏省肿瘤医院食管癌术后鼻饲肠内营养患者,构建并实施连续性药学服务流程,采用欧洲医药保健网(PCNE)分类系统和Morisky调查问卷,评价药学服务前后用药相关问题(DRPs)和用药依从性,探讨连续性药学服务价值。结果 共纳入52例食管癌术后鼻饲肠内营养的住院患者,其中48例患者入院时存在DRPs(共计78个),包括58个治疗有效性DRPs、8个安全性DRPs和12个不必要的药物治疗DRPs。实施连续性药学服务后,存在DRPs患者例数减少[22(42.31%)vs.48(92.30%),P<0.05],DRPs类型较入院时减少,其中治疗有效性、不必要的药物治疗较为明显;第1次回访时用药依从性评分显著高于入院时[(3.44±0.40)vs.(2.65±1.24),P<0.05],第2次回访时(3.87±0.40)显著高于入院时和第1次回访时(P<0.05)。结论 接受鼻饲肠内营养的食管癌患者发生DRPs的数量和类型较多,通过构建并实施连续性药学服务,可减少DRPs发生,提高用药依从性。Objective To explore the impact of continuous pharmaceutical care on drug-related problems and compliance in esophageal cancer patients undergoing nasojejunal nutrition therapy.Methods Patients with esophageal cancer undergoing nasojejunal nutrition therapy in the Jiangsu Cancer Hospital from April to September 2022 were selected to construct and implement a continuous pharmaceutical care process.Pharmaceutical Care Network Europe(PCNE)classification system and Morisky questionnaire were used to evaluate drug-related problems(DRPs)and compliance on medication before and after pharmaceutical care,and to explore the value of continuous pharmaceutical care.Results A total of 52 hospitalized patients receiving postoperative nasojejunal nutrition therapy for esophageal cancer were included,of which 48 patients had a total of 78 DRPs on admission,including 58 concerning treatment effectiveness,8 concerning safety,and 12 concerning unnecessary drug treatment.After the implementation of continuous pharmaceutical care,there was a significant decrease in the number of patients with DRPs[22(42.31%)vs.48(92.30%),P<0.05].The type of DRPs decreased compared to that on admission,particularly DRPs related treatment effectiveness and unnecessary medication.The score of medication compliance on the first return visit was significantly higher than that on admission[(3.44±0.40)vs.(2.65±1.24),P<0.05],and the second return visit(3.87±0.40)was significantly higher than that on admission and the first return visit(P<0.05).Conclusion The number and types of DRPs in esophageal cancer patients undergoing nasojejunal nutrition therapy are relatively large.Constructing and implementing continuous pharmaceutical care can effectively reduce DRPs and improve compliance on medication,reflecting the value of targeted and continuous pharmaceutical care in this special patient group.

关 键 词：鼻饲肠内营养 食管癌 连续性药学服务 用药相关问题 用药依从性 

分 类 号：R735.1[医药卫生—肿瘤] R969[医药卫生—临床医学]