药物治疗管理模式对居家冠状粥样硬化性心脏病患者用药影响与效果分析  

Analysis of the impact and effect of medication therapy management model on home-based coronary heart disease patients

作　　者：王晓燕[1] 刘耀梅 黄秀秀[1] 舒美春[1] 胡杰[1] WANG Xiaoyan;LIU Yaomei;HUANG Xiuxiu;SHU Meichun;HU Jie(Department of Cardiovascular Medicine,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州医科大学附属第一医院心血管内科,浙江温州325000

出　　处：《药学前沿》2025年第2期243-250,共8页China Pharmacist

基　　金：温州市科研项目(Y20220101)。

摘　　要：目的探讨药物治疗管理(MTM)对居家冠状粥样硬化性心脏病(CHD)患者的影响。方法回顾性分析2023年6月至2024年6月温州医科大学附属第一医院心血管内科CHD患者资料。根据药学服务方式不同分为对照组(接受常规指导)和MTM组(在常规医护基础上增加MTM药学服务),观察两组患者生活质量(SAQ)评分、用药依从性(MMAS-8)评分、左心功能参数[左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)]、血清N末端B型利钠肽前体(NT-proBNP)水平及主要不良心血管事件(MACE)和再住院情况。结果研究共纳入200例CHD患者,对照组109例,MTM组91例。干预3个月后,MTM组SAQ量表各维度评分、MMAS-8总分、LVEF水平显著高于对照组(P<0.05),且高依从性比例显著增加(P<0.05);LVESD、LVEDD和NTproBNP水平显著低于对照组(P<0.05)。MTM组总MACE发生率低于对照组(P<0.05),但再住院率差异无统计学意义(P>0.05)。结论基于MTM服务模式的药学干预改善了CHD患者的生活质量、用药依从性和心功能指标,减少了MACE发生率。Objective To evaluate the effectiveness of medication therapy management(MTM)in patients with coronary heart disease(CHD)receiving home care.Methods A retrospective analysis was conducted on the data of CHD patients in the Department of Cardiology,The First Affiliated Hospital of Wenzhou Medical University from June 2023 to June 2024.According to different pharmaceutical service methods,patients were divided into a control group(receiving routine guidance)and a MTM group(adding MTM pharmaceutical services on the basis of routine medical care).The quality of life(SAQ score),medication adherence(MMAS-8 score),left ventricular function parameters(LVESD,and LVEDD,LVEF),serum NT pro BNP levels(NT-proBNP),major adverse cardiac events(MACE),and readmission were observed.Results A total of 200 patients with CHD were included in the study,with 109 in the control group and 91 in the MTM group.After 3 months of intervention,the scores of various dimensions of the SAQ scale,MMAS-8 score,and LVEF level in the MTM group were significantly higher than those in the control group(P<0.05),and the proportion of high compliance increased significantly(P<0.05);The levels of LVESD,LVEDD,and NT-proBNP were significantly lower than those in the control group(P<0.05).The total incidence of MACE in the MTM group was lower than that in the control group(P<0.05),but the difference in readmission rate was not statistically significant(P>0.05).Conclusion MTM services significantly improve the quality of life,medication adherence,and cardiac function parameters in CHD patients,while reducing the incidence of MACE.

关 键 词：药物治疗管理模式 冠状粥样硬化性心脏病 居家治疗 药学服务 门诊药学 依从性 主要不良心血管事件 

分 类 号：R471[医药卫生—护理学]