基于智慧药学服务平台的呼吸与危重症医学咳喘医药联合门诊对慢性阻塞性肺疾病患者药学服务干预效果分析

    Effect Analysis of Pharmaceutical Care Interventions on Chronic Obstructive Pulmonary Disease Patients in the Cough & Wheeze Physician-Pharmacist Joint Clinic of Pulmonary and Critical Care Medicine Based on the Intelligent Pharmaceutical Care Platform

    • 摘要:
      目的 探索基于智慧药学服务平台的呼吸与危重症医学(pulmonary and critical care medicine,PCCM)咳喘医药联合门诊对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者药学服务干预的应用价值。
      方法 选取2021年7月—2022年6月于南通大学附属医院PCCM咳喘医药联合门诊就诊的COPD患者200例,按照随机数字法分为对照组100例和实验组100例。对照组患者接受常规用药指导和健康宣教,实验组在对照组的基础上成立以临床药师为主导的药学服务团队,基于智慧药学服务平台对COPD患者进行标准化、个性化管理。比较2组患者在治疗效果和生存质量上的差异。
      结果 实验组患者的第1秒用力呼气量占预计值的百分比(lung function index of forced expiratory volume in one second percent,FEV1%)和第1秒用力呼气量占用力肺活量的百分比(forced expiratory volume in one second/forced vital capacity,FEV1/FVC%)显著高于对照组(P<0.05),COPD患者自我评估评分表(COPD Assessment Test,CAT)评分显著低于对照组(P<0.05)。实验组的Morisky用药依从性量表(Eight-item Morisky Medication Adherence Scale,MMAS-8)评分显著高于对照组(P<0.05)。实验组吸入装置的错误使用率和药物不良反应发生率显著低于对照组(P<0.05)。实验组的6 min步行试验(6-minute walk test,6MWT)结果显著高于对照组(P<0.05)。实验组的圣乔治呼吸问卷(St George’s Respiratory Questionnaire,SGRQ)权重评分低于对照组(P<0.05)。实验组患者对药学服务的满意度高于对照组(P<0.05)。
      结论 基于智慧药学服务平台探索的PCCM咳喘医药联合门诊的药学服务模式对COPD患者的管理可显著改善患者肺功能和治疗效果,提高患者用药依从性,减少药物不良反应,提升患者活动耐力和生存质量。

       

      Abstract:
      OBJECTIVE To explore the application value of pharmaceutical care interventions on chronic obstructive pulmonary disease(COPD) patients in the cough & wheeze physician-pharmacist joint clinic of pulmonary and critical care medicine(PCCM) based on the intelligent pharmaceutical care platform.
      METHOD A total of 200 COPD patients who received treatment in the cough & wheeze physician-pharmacist joint clinic of PCCM of Affiliated Hospital of Nantong University between July 2021 and June 2022 were selected. These patients were randomly assigned to a control group(100 cases) and an experimental group(100 cases) according to random number method. The control group received routine medication guidance and health education. The experimental group, in addition to the control group, established a clinical pharmacists-led pharmaceutical care team based on the intelligent pharmaceutical care platform to standardize and individualize the management of COPD patients. The differences in treatment effect and quality of life were compared between the two groups.
      RESULT The lung function index of forced expiratory volume in one second percent(FEV1%) and the forced expiratory volume in one second/forced vital capacity (FEV1/FVC%) were significantly higher in the experimental group than those in the control group(P<0.05), and the COPD Assessment Test(CAT) scores were significantly lower in the experimental group than those in the control group(P<0.05). The Eight-item Morisky Medication Adherence Scale(MMAS-8) scores in the experimental group were significantly higher than those in the control group(P<0.05). The rate of improper use of the inhalation device and the incidence of adverse drug reactions in the experimental group was significantly lower than those in the control group(P<0.05). The 6-minute walk test(6MWT) results in the experimental group were significantly higher than those in the control group(P<0.05). The St George’s Respiratory Questionnaire(SGRQ) weight scores in the experimental group were significantly lower than those in the control group(P<0.05). The satisfaction rate of patients in the experimental group with pharmaceutical care were significantly higher than that in the control group(P<0.05).
      CONCLUSION The management of patients with COPD in the cough & wheeze physician-pharmacist joint clinic of PCCM based on the intelligent pharmaceutical care platform can significantly improve the patients’ lung function and treatment effect, increase the patients’ medication compliance, reduce the ADRs, and enhance the patients’ activity endurance and quality of life.

       

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