基于移动技术的居家老年慢病远程药物治疗管理模式建立与评价  

Establishment and Evaluation of A Remote Medication Treatment Management Model for Elderly Patients with Chronic Diseases Based on Mobile Technology

作　　者：杨丽娟 张威 李全志 郑婷婷 杨烁 林平 韩爽 刘思彤 张天婧 甄健存 YANG Lijuan;ZHANG Wei;LI Quanzhi;ZHENG Tingting;YANG Shuo;LIN Ping;HAN Shuang;LIU Sitong;ZHANG Tianjing;ZHEN Jiancun(Department of Pharmacy,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院药学部,北京100035

出　　处：《医药导报》2025年第3期486-490,共5页Herald of Medicine

基　　金：北京市科技计划专项课题(Z19110000-4419004)。

摘　　要：目的评价基于移动技术的居家老年慢病远程药物治疗管理模式的效果和可行性。方法开发便捷友好的移动应用软件(简称“药事宜”APP),组建由三甲医院临床药师-社区药师-社区医师组成的远程药物治疗管理团队,从社区选取居家老年慢病患者进行实践研究,应用“药事宜”APP对患者进行为期6个月的药物治疗管理,考察实践效果和可行性。结果“药事宜”APP能与多种医疗级可穿戴设备集成连接,实现自动上传监测数据、异常值提醒、用药提醒、用药咨询、用药科普等功能。共有302例居家老年慢病患者完成研究,发现并干预药物治疗问题695例次,药物治疗问题排序前3位的是需要额外增加的治疗247例次(35.5%)、不必要的药物治疗97例次(14.0%)、用药依从性问题93例次(13.4%)。患者用药依从性评分从入组时的(5.85±1.57)分上升至入组6个月后的(6.74±1.23)分(P<0.01),入组6个月后患者对药师工作的满意度评分达(4.99±0.08)分(满分5分),患者平均减少药品费用比例(20.9±18.0)%。93.4%的患者能熟练掌握“药事宜”APP的使用。结论基于移动技术的居家老年慢病远程药物治疗管理模式能有效提高患者对疾病监测和用药的依从性,保障患者合理用药,减少医疗资源浪费,患者接受度高。Objective To evaluate the effectiveness and feasibility of a remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology.Methods A convenient and elderly-friendly mobile application(hereinafter referred to as Yaoshiyi APP)was developed,and a remote medication treatment management team consisting of clinical pharmacists from tertiary hospitals,community pharmacists,and community physicians was formed.Patients from communities were selected for practical research,led by pharmacists.Based on the Yaoshiyi APP,patients were subjected to 6 months of medication treatment management practice,and the effectiveness and feasibility of the practice were evaluated.Results The Yaoshiyi APP can be integrated with a variety of medical-grade wearable devices to realize the functions of automatically uploading monitoring data,abnormal value reminding,medication reminding,medication consultation,and medication science popularization.A total of 302 elderly patients with chronic disease at home completed the study.The results showed that pharmacists have identified and intervened in 695 cases of medication-related problems.According to the classification of medication-related problems,the top three were 247 cases(35.5%)of additional treatment,97 cases(14.0%)of unnecessary drug treatment,and 93 cases(13.4%)of medication compliance problems.The patient's medication adherence score(Morisky medication adherence scale-8,MMAS-8)increased from(5.85±1.57)at enrollment to(6.74±1.23)6 months after enrollment(P<0.01).After 6 months of enrollment,the patient's satisfaction with the pharmacist's work reached a score of(4.99±0.08)out of 5.The average reduction in drug costs for patients caused by pharmacists intervening in irrational medication is(20.9±18.0)%.At the end of follow-up,93.4%of patients were proficient in using the Yaoshiyi APP.Conclusion The remote medication treatment management model for elderly patients with chronic disease at home based on mobile technology constru

关 键 词：移动应用 居家老年慢病患者 药物治疗管理 

分 类 号：R95[医药卫生—药学]