欧洲医药保健网分类系统用于脑梗死患者药物治疗管理实践  

Practice of PCNE Classification System in Medication Therapy Management for Patients with Cerebral Infarction

作　　者：林海霞 黄玲梅 赵丹洁 李霞 官真水 LIN Haixia;HUANG Lingmei;ZHAO Danjie;LI Xia;GUAN Zhenshui(Shuangliu District First People′s Hospital·West ChinaHospital,Sichuan University,Chengdu,Sichuan,China 610200)

机构地区：[1]四川省成都市双流区第一人民医院·四川大学华西医院空港医院,四川成都610200

出　　处：《中国药业》2024年第3期120-124,共5页China Pharmaceuticals

基　　金：四川省医院协会青年药师科研专项资金项目[22048];四川省成都市医学科研课题[2022562];成都药学会-赞邦药学科研基金资助[202109]。

摘　　要：目的探讨临床药师在药物治疗管理(MTM)中基于欧洲医药保健网(PCNE)分类系统识别脑梗死患者药物相关问题(DRP)的作用,以及对干预效果的影响。方法选取医院2022年6月至9月收治的脑梗死住院患者80例,按随机数字表法分为对照组和干预组,各40例。对照组患者给予传统治疗模式;干预组患者在对照组基础上开展MTM,采用PCNE分类系统识别DRP,分析DRPs的问题类型和原因类型,提供介入方案,并了解医师和患者对介入方案的接受情况及DRP的解决状态。两组患者均随访至出院后1个月。结果干预组中,共发现DRP 45例次,其中治疗效果问题21例次(46.67%),治疗安全性问题14例次(31.11%),其他问题10例次(22.22%);DRP原因47例次,其中药物选择相关原因26例次(55.32%),剂量选择相关原因12例次(25.53%),患者相关原因7例次(14.89%),治疗疗程相关原因2例次(4.26%);医师和患者完全接受介入方案35例次(77.78%),DRP全部解决37例次(82.22%)。与治疗前比较,干预组患者出院时与出院1个月后的中医证候积分均明显降低(P<0.05),且明显低于对照组(P<0.05);干预组患者出院时Morisky药物依从性量表评分明显升高(P<0.05),且明显高于对照组(P<0.05);两组患者出院时及出院1个月后的美国国立卫生研究院卒中量表评分均明显降低(P<0.05)。结论临床药师对脑梗死患者实施MTM和PCNE分类系统的药学监护,可识别并解决DRPs,改善患者中医证候和病情严重程度,提高患者用药依从性,且医师接受程度高。Objective To investigate the role of clinical pharmacists in identifying drug-related problems(DRPs)in patients with cerebral infarction based on the Pharmaceutical Care Network Europe(PCNE)classification system in medication therapy management(MTM),and its effect on patients′clinical outcomes.Methods A total of 80 inpatients with cerebral infarction admitted to the hospital from June to September 2022 were selected and randomly divided into the control group and the intervention group by the random number table method,with 40 cases in each group.The patients in the control group were given traditional treatment mode,while the patients in the intervention group were given pharmaceutical care on the basis of the control group.The PCNE classification system was used to identify DRPs,analyzed the types of problems and causes of DRPs,provide intervention plans,and understand the acceptance of intervention plans by physicians and patients and the resolution status of DRPs.Results A total of 45 DRPs were found in the intervention group,with 21 efficacy problems(46.67%),14 safety problems(31.11%)and 10 other problems(22.22%).There were 47 reasons for DRPs,among which 26 cases were related to medication selection(55.32%),12 cases were related to dose selection(25.53%),7 cases were related to patients(14.89%),and 2 cases were related to treatment course(4.26%).A total of 35 cases(77.78%)were fully accepted by the physician and patient intervention plan,and all 37 cases of DRPs(82.22%)were resolved.Compared with those before treatment,the scores of traditional Chinese medicine syndrome at discharge and one month after discharge in the intervention group were significantly lower(P<0.05),and were significantly lower than those in the control group(P<0.05).The score of 8-item Morisky Medication Adherence Scale(MASS-8)at discharge in the intervention group was significantly higher(P<0.05),and was significantly higher than that in the control group(P<0.05).Both groups showed a significant decrease in the score of the National

关 键 词：药物治疗管理 欧洲医药保健网分类系统 药物相关问题 药学监护 脑梗死 临床药师 

分 类 号：R95[医药卫生—药学]