慢性阻塞性肺疾病急性加重入院危险因素分析及药学服务模型构建  

Construction of the Pharmaceutical Care Model Based on Risk Factors of Admission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：王阿明 黄磊 张琳琳 石爱平[2] 常晓敏 WANG Aming;HUANG Lei;ZHANG Linlin;SHI Aiping;CHANG Xiaomin(Yancheng No.1 People′s Hospital,Yancheng,Jiangsu,China 224005;Taixing People′s Hospital,Taizhou,Jiangsu,China 225400)

机构地区：[1]江苏省盐城市第一人民医院,江苏盐城224005 [2]江苏省泰兴市人民医院,江苏泰州225400

出　　处：《中国药业》2025年第7期16-20,共5页China Pharmaceuticals

基　　金：江苏省药学会-恒瑞医院药学基金科研项目[H202148]。

摘　　要：目的 提升慢性阻塞性肺疾病(COPD)急性加重入院的药学服务质量。方法 选取2023年1月至12月在江苏省盐城地区伍佑、先锋、海悦的社区卫生服务中心建立居民健康档案的COPD患者142例,根据患者既往1年内是否因COPD急性加重入院分为入院组(65例)和未入院组(77例)。收集患者的性别、年龄、合并症、体质量指数(BMI)、COPD病程、嗜酸性粒细胞百分比(EOS%)、低蛋白血症等基本情况,既往1年内COPD急性发作次数、用药依从性、合并用药数、吸入装置正确使用情况等数据,通过单因素和多因素Logistic回归分析COPD患者1年内急性加重入院的危险因素,并构建药学服务模型。结果 单因素分析结果显示,两组患者的BMI、病程、EOS%、低蛋白血症、吸入装置使用的正确性、用药依从性、合并用药数均有显著差异(P<0.05)。多因素Logistic回归分析结果显示,BMI(≤24 kg/m^(2))、EOS%≥2%、低蛋白血症(<35 g/L)、未正确使用吸入装置是1年内急性加重入院的独立危险因素(P<0.05)。基于这些独立危险因素,将患者分为高危、中危、低危人群,从随访频次、随访实施者、具体随访内容等方面构建了标准化药学服务模型。结论 基于COPD急性加重入院的高危因素,快速筛选高危人群,有针对性地开展精细化药学服务,可极大地提高COPD急性加重药学服务的效率与质量。Objective To improve the quality of pharmaceutical care for patients admitted with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 142 COPD patients who established resident health records in Wuyou,Xianfeng and Haiyue Community Health Service Centers in Yancheng,Jiangsu Province from January to December 2023 were selected,and they were divided into the admission group(65 cases)and the non-admission group(77 cases)based on whether the patients were admitted due to acute exacerbation of COPD(AECOPD)in the previous year.Basic information such as gender,age,comorbidities,body mass index(BMI),COPD duration,eosinophil percentage(EOS%),hypoalbuminemia,as well as frequency of AECOPD in the previous year,medication compliance,number of combined drugs,and correct use of inhaled drugs were collected.Univariate analysis and multivariate Logistic regression analysis were used to analyze the risk factors of admission for AECOPD patients within the previous year,and the pharmaceutical care model was constructed.Results Univariate analysis showed that the BMI,disease duration,EOS%,hypoalbuminemia,correct use of inhaled drugs,medication adherence,and number of combined drugs between the two groups were significantly different(P<0.05).Multivariate Logistic regression analysis showed that BMI(≤24 kg/m^(2)),EOS%≥2%,hypoproteinemia(<35 g/L)and incorrect use of inhaled drugs were independent risk factors of admission for AECOPD patients within one year(P<0.05).Based on these independent risk factors,patients were divided into high-risk,medium-risk,and low-risk groups,and a standardized pharmaceutical care model was constructed from the aspects of follow-up frequency,follow-up implementers,and specific follow-up content.Conclusion Based on the high-risk factors of admission for AECOPD patients,rapid screening of high-risk groups and targeted implementation of refined pharmaceutical care can greatly improve the efficiency and quality of pharmaceutical care for AECOPD patients.

关 键 词：慢性阻塞性肺疾病急性加重 入院危险因素 药学服务 

分 类 号：R95[医药卫生—药学]