药物重整对冠心病合并高血压患者的管理效果评价  

Evaluation of the management effect of medication reconciliation on patients with coronary heart disease and hypertension

作　　者：杨翠[1] 钱倩倩 代雪飞 Yang Cui;Qian Qianqian;Dai Xuefei(Department of Pharmacy,the First Affiliated Hospital of Anhui Medical University,Anhui Public Health Clinical Center,Hefei 230012,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Anhui Medical University,Anhui Public Health Clinical Center,Hefei 230012,China)

机构地区：[1]安徽医科大学第一附属医院(安徽省公共卫生临床中心)药学部,安徽合肥230012 [2]安徽医科大学第一附属医院(安徽省公共卫生临床中心)心血管内科,安徽合肥230012

出　　处：《实用药物与临床》2025年第3期211-215,共5页Practical Pharmacy and Clinical Remedies

基　　金：安徽省高校科研项目(2022AH050641);院科研培育基金项目(2024YKJ13);安徽省公共卫生临床中心重点专科建设项目(2023年)。

摘　　要：目的评价以临床药师为主导的药物重整对冠心病合并高血压患者的管理效果。方法将2022年3月至2023年10月安徽医科大学第一附属医院的100例冠心病合并高血压的住院患者随机分为干预组和对照组,每组50例。对照组患者接受常规治疗(无药师服务),干预组患者除接受常规治疗外,还接受临床药师提供的药物重整服务。两组患者均随访至出院后6个月,并在随访时间点接受药物重整服务,比较两组患者不同时间点的依从性、血压达标率、出院后用药偏差、药品不良反应(ADR)发生率以及出院后患者满意度等。结果两组患者的基本资料比较差异无统计学意义(P>0.05),住院期间干预组患者有43例存在用药偏差,平均每人至少1.9个,需要干预的48个,干预医嘱采纳率为95.83%。出院后3个月,干预组患者的依从性评分[7.00(6.00,7.00)分vs.6.00(6.00,7.00)分]、血压达标率(74.00%vs.54.00%)、非常满意患者占比(58.00%vs.42.00%)较对照组明显提高(P<0.05);干预组的用药偏差发生率及ADR发生率均低于对照组(30.00%vs.52.00%,16.00%vs.34.00%),差异有统计学意义(P<0.05)。出院后6个月,干预组、对照组患者的依从性评分分别为7.63(7.00,8.00)分、7.00(7.00,8.00)分,两组间差异具有统计学意义(P<0.05),而血压达标率、用药偏差及ADR发生情况差异无统计学意义(P>0.05);干预组、对照组非常满意患者占比均明显高于出院后3个月(P<0.01)。结论临床药师主导的药物重整服务能够提高冠心病合并高血压患者的依从性、血压达标率及满意度,减少用药偏差及ADR的发生率。Objective To evaluate the management effect of medication reconciliation led by clinical pharmacists on patients with coronary heart disease and hypertension.Methods Totally 100 patients with coronary heart disease and hypertension admitted to the Anhui Public Health Clinical Center from March 2022 to October 2023 were randomly divided into the intervention group(50 cases)and the control group(50 cases).The control group received routine treatment(no pharmacist services),while the intervention group received medication reconciliation services provided by clinical pharmacists in addition to routine treatment.The two groups of patients were followed up until 6 months after discharge,and medication reorganization services were provided at each follow-up time point.Compliance,the blood pressure compliance rate,post-discharge medication deviation,incidence of adverse drug reactions(ADRs),and patient satisfaction after discharge were compared between the two groups at different time points.Results There was no significant difference in the basic information between the two groups of patients(P>0.05).During hospitalization,43 patients in the intervention group had medication deviation,with an average of at least 1.9 per patient,and 48 patients needed intervention.The acceptance rate of intervention advice was 95.83%.Three months after discharge,the compliance score[7.00(6.00,7.00)vs.6.00(6.00,7.00)],blood pressure compliance rate(74.00%vs.54.00%),and proportion of very satisfied patients(58.00%vs.42.00%)in the intervention group were significantly higher than those in the control group(P<0.05);the incidence of medication deviation and the incidence of ADR were lower in the intervention group than in the control group(30.00%vs.52.00%,16.00%vs.34.00%),and the differences were of statistical significance(P<0.05).Six months after discharge,the compliance scores of the intervention group and the control group were 7.63(7.00,8.00)and 7.00(7.00,8.00),respectively,and there was a significant difference between the two groups(P<

关 键 词：冠心病 高血压 药物重整 临床药师 依从性 

分 类 号：R47[医药卫生—护理学]