家庭药师服务模式管理老年高血压患者的药物经济学评价  

Pharmacoeconomic Evaluation of Family Pharmacist Service Model in the Management of Elderly Patients with Hypertension

作　　者：高艳玲 周敏华 区惠燕 GAO Yan-Ling;ZHOU Min-Hua;OU Hui-Yan(Department of Pharmacy,Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Foshan 528200,China;Guicheng Community Health Service Center,Nanhai District,Foshan 528200,China)

机构地区：[1]广东省中西医结合医院药学部,广东佛山528200 [2]佛山市南海区桂城街道社区卫生服务中心,广东佛山528200

出　　处：《中国药物经济学》2024年第4期24-28,共5页China Journal of Pharmaceutical Economics

基　　金：佛山市卫生健康局医学科研课题(20210338);佛山市“十四五”中医重点专科(ZDZKJS45);佛山市“十四五”高水平医学重点专科(FSGSP145088);佛山市南海区“十四五”重点专科(南卫健[2021]211号);佛山市中医药临床科技创新基地(佛卫函[2022]35号)。

摘　　要：目的评价对老年高血压患者实施家庭药师服务的经济学价值。方法选取佛山市南海区桂城社区的200例老年高血压患者作为研究对象,随机分为对照组与观察组,各100例。对照组由专科医生制定和调整治疗方案,以及进行必要的诊疗干预,观察组在对照组基础上接受家庭药师服务干预。两组患者均随访12个月,在干预前、随访6个月及随访12个月时采用欧洲五维度五水平健康量表(EQ-5D-5L)采集患者的健康数据并获得健康描述系统和视觉模拟量表(EQ-VAS)评分,再结合中国EQ-5D-5L效用积分体系表计算质量调整生命年(QALYs)作为效用指标;研究期间干预措施产生的费用作为成本指标,采用成本-效用分析法进行药物经济学评价。结果与对照组比较,观察组直接医疗成本、间接成本以及总成本均较低,但差异无统计学意义(P>0.05);对照组和观察组因发生心脑血管事件住院的分别为14例和6例;随访12个月时,观察组效用值和VAS评分明显高于对照组(P<0.05);观察组效用值及VAS评分在随访12个月时均显著高于干预前(P<0.05),对照组未见明显变化(P>0.05);与对照组比较,观察组每增加1个QALY同时减少31592.77元的费用。结论以药师为主导的居家药学服务模式对老年高血压患者有明确的经济学获益,降低治疗成本同时可改善其生命质量。Objective To evaluate the economic value of family pharmacist service for elderly patients with hypertension.Methods A total of 200 elderly hypertensive patients in Guicheng community,Nanhai District,Foshan City were selected as the study objects and randomly divided into control group and observation group,with 1oo cases in each group.In the control group,the doctors made and adjusted the treatment plan,and carried out the necessary diagnosis and treatment intervention,the observation group received family pharmacist service intervention on the basis of the control group.All patients were followed up for 12 months.The health data and EQ-VAS scores were collected by using the modified European 5-Dimension Health Scale before intervention and at 6-month and 12-month follow-up,the quality adjusted life years(QALYs)were calculated as the utility index in combination with the China EQ-5D-5L utility score system;the cost of all interventions during the study is used as a cost indicator,cost-utility analysis method was used for pharmacoeconomic analysis.Results Compared with the control group,the direct medical cost,indirect cost and total cost of the observation group were lower,but the difference was not significant(P>0.05);there were 14 cases and 6 cases in the control group and the observation group hospitalization due to cardiovascular and cerebrovascular events;at 12 months follow-up,the utility value and VAS score of the observation group were significantly higher than those of the control group(P<0.05);the utility value and VAS score of the observation group were significantly higher than those before intervention(P<0.05),while no significant change was found in the control group(P>0.05);compared with the control group,the cost of each additional QALYs in the observation group decreased by 31592.77 yuan.Conclusion Pharmacist-led home pharmaceutical care model has clear economic benefits for chronic disease management of elderly patients with hypertension,reducing the cost of treatment and improving their qualit

关 键 词：家庭药师 老年高血压 药物经济学评价 

分 类 号：R544.1[医药卫生—心血管疾病] R956[医药卫生—内科学]