癫痫患儿分级药学监护路径的建立与效果评价  

Development and clinical outcome assessment a stratified pharmaceutical care pathway for pediatric epilepsy patients

作　　者：孙艳 韩宁蕙 Sun Yan;Han Ninghui(Department of Pharmacy,Friendship Hospital of Ili Kazakh Autonomous Prefecture,Yining,Xingjiang Uyghur Autonomous Region 835000,China;Department of Pharmacy,Yining People'Hospital,Yining,Xinjiang Uyghur Autonomous Region 835000,China)

机构地区：[1]伊犁哈萨克自治州友谊医院药剂科,新疆维吾尔自治区伊宁835000 [2]伊宁市人民医院药剂科,新疆维吾尔自治区伊宁835000

出　　处：《中国药物与临床》2025年第7期440-446,共7页Chinese Remedies & Clinics

基　　金：伊犁哈萨克自治州科技计划项目(YYD2023A21)。

摘　　要：目的建立基于癫痫患儿疾病特点的分级药学监护路径,并评价其应用效果。方法选取2021年11月至2023年11月伊犁哈萨克自治州友谊医院接诊的癫痫患儿126例,分为对照组(常规药物监护)、试验组(分级药学监护路径),每组63例。比较干预前、干预3个月后、干预6个月后2组用药依从性、认知功能;比较2组癫痫发作控制效果、再入院率、药物不良反应、家长药学服务满意度。结果重复测量方差分析显示,2组Morisky服药依从性量表(MMAS-8)评分、简易精神状态检查表(MMSE)评分在组间、时间均存在交互作用(P<0.05);组间比较:干预前2组MMAS-8评分、MMSE评分比较[(3.3+0.7)分、(3.5±0.6)分和(21.8±3.3)分、(21.9±3.2)分]差异无统计学意义(P>0.05);千预3、6个月后试验组MMAS-8评分、MMSE评分均高于对照组[(4.8±0.9)分、(4.2±0.8)分和(24.6±3.2)分、(23.0±3.2)分](P<0.05);千预6个月后试验组MMAS-8评分、MMSE评分均高于对照组[(6.0±1.2)分、(5.2±1.0)分和(26.6±3.0)分、(24.9±3.1)分](P<0.05)。试验组癫痫控制总有效率、家长药学服务满意度均高于对照组(92.1%、77.8%和95.2%、82.5%)(P<0.05),再入院率、药物不良反应发生率低于对照组(4.8%、17.5%和4.8%、17.5%)(P<0.05)。结论基于癫痫患儿疾病特点的分级药学监护路径可提高患儿用药依从性、认知功能、癫痫控制效果及家长药学服务满意度,减少再人院及药物不良反应。Objective To develop and evaluate a graded pharmaceutical care pathway tailored to the unique characteristics of pediatric epilepsy.Methods Admited to Yili Kazakh Autonomous Prefecture Friendship Hospital between November 2021 and November 2023,a total of 126 pediatric epilepsy patients were divided into a control group(n=63,receiving routine pharmaceutical care)and an experimental group(n=63,receiving the graded pharmaceutical care).Medication adherence and cognitive function were assessed before the intervention,as well as at 3 months and 6 months post-intervention.Additional outcome measurements included seizure control efficacy,re-hospitalization rates,adverse drug reaction incidence,and parental satisfaction with pharmaceutical services:Results The repeated-measures analysis of variance(ANOVA)revealed significant interaction effects between groups,time,and group-by-time interactions in both the Morisky Medication Adherence Scale(MMAS-8)scores and Mini-Mental State Examination(MMSE)scores(P<0.05).Between group comparisons showed no statistically significant differences in baseline MMAS-8 scores or MMSE scores between the two groups before the intervention[(3.30.7 vs,3.5±0.6)and(21.8±3.3 us.21.9±3.2),respectively,P>0.05].After 3 months of intervention,the experimental group demonstrated significantly higher MMAS-8 and MMSE scores compared to the control group[(4.8±0.9 vs.4.2±0.8)and(24.6±3.2 vs.23.0±3.2),respectively,P<0.05].This superiority persisted at 6 months post-intervention,with the experimental group maintaining higher scores[(6.0±1.2 vs.5.2±1.0)and(26.6±3.0 vs.24.9±3.1),respectively,P<0.05].The experimental group also exhibited significantly better outcomes in epilepsy control efficacy(92.1%vs.77.8%),parental satisfaction with pharmaceutical care(95.2%vs.82.5%),while demonstrating lower rates of hospital readmission(4.8%vs.17.5%)and adverse drug reactions(4.8%vs.17.5%)compared to the control group(all P<0.05).Conclusion A graded pharmaceutical care pathway based on the disease characteristi

关 键 词：癫痫 分级药学监护 依从性 满意度 

分 类 号：R742.1[医药卫生—神经病学与精神病学]