远程药学服务对初诊高血压患者用药疗效及安全性的影响  

Effect of Remote Pharmaceutical Care on the Efficacy and Safety of Medication in Patients with Newly-Diagnosed Hypertension

作　　者：陆文静 王秦 李晓烨[1] 戴佩芳[1] 叶岩荣[1] 李晓宇 吕迁洲[1] 邹烨[1] LU Wenjing;WANG Qin;LI Xiaoye;DAI Peifang;YE Yanrong;LI Xiaoyu;LYU Qianzhou;ZOU Ye(Zhongshan Hospital,Fudan University,Shanghai,China 200032;Shanghai Geriatrics Center,Shanghai,China 201100)

机构地区：[1]复旦大学附属中山医院,上海200032 [2]上海市老年医学中心,上海201100

出　　处：《中国药业》2024年第4期22-26,共5页China Pharmaceuticals

基　　金：上海市临床重点专科项目[shslczdzk06504]。

摘　　要：目的探讨远程药学服务模式对初诊高血压患者用药疗效及安全性的影响。方法选取复旦大学附属中山医院2020年8月至2021年6月收治的初次诊断为高血压的患者355例,按随机数字表法分为对照组(178例)和干预组(177例)。两组患者均接受常规医疗服务;干预组增加远程药学服务(即临床药师发放用药指导单,并通过电话或微信对患者进行随访,每周1次)。6个月后,比较两组患者的用药疗效、依从性、安全性等方面的指标。结果干预组患者舒张压(校正后)显著低于对照组[(77.54±0.57)mmHg比(85.00±0.56)mmHg,P<0.001],血压达标率显著高于对照组(84.43%比69.41%,P=0.001);干预组患者用药依从性评分显著优于对照组[(1.78±0.69)分比(2.05±0.76)分,P=0.001],药物了解程度评分显著优于对照组[(1.45±0.65)分比(2.77±0.44)分,P<0.001]。干预组不良反应发生率显著低于对照组(13.17%比22.94%,P=0.020),再入院发生率显著低于对照组(2.99%比14.71%,P=0.002)。结论远程药学服务可有效改善初诊高血压患者用药的疗效、依从性及安全性。Objective To investigate the effect of remote pharmaceutical care on the efficacy and safety of medication in patients with newly-diagnosed hypertension.Methods A total of 355 patients with newly-diagnosed hypertension at the Zhongshan Hospital,Fudan University from August 2020 to June 2021 were selected and divided into the control group(178 cases)and the intervention group(177 cases)by the random number table method.The patients in the two groups were given conventional medical service,on this basis,the patients in the intervention group were given remote pharmaceutical care,including receiving medication guidance forms and follow-up once a week via phone or WeChat by clinical pharmacists.After six months,the indexes related to medication efficacy,adherence and safety between the two groups were compared.Results The diastolic blood pressure(after correction)in the intervention group was significantly lower than that in the control group[(77.54±0.57)mmHg vs.(85.00±0.56)mmHg,P<0.001],the standard-reaching rate of blood pressure was significantly higher than that in the control group(84.43%vs.69.41%,P=0.001).The medication adherence score in the intervention group was significantly better than that in the control group[(1.78±0.69)points vs.(2.05±0.76)points,P=0.001],the drug understanding score was significantly better than that in the control group[(1.45±0.65)points vs.(2.77±0.44)points,P<0.001].The incidence of adverse reactions in the intervention group was significantly lower than that in the control group(13.17%vs.22.94%,P=0.020),the incidence of readmission was significantly lower than that in the control group(2.99%vs.14.71%,P=0.002).Conclusion Remote pharmaceutical care can effectively improve the efficacy,adherence and safety of medication in patients with newly-diagnosed hypertension.

关 键 词：远程药学服务 初诊 高血压 疗效 依从性 安全性 

分 类 号：R95[医药卫生—药学]