数智赋能儿童哮喘全病程药学服务模式构建与实践

    Construction and Practice of a Digital-Intelligent Empowered Full-Course Pharmaceutical Care Model for Pediatric Asthma

    • 摘要:
      目的  借助数智技术构建儿童哮喘全病程药学服务模式并通过实践验证成效,为更多儿童慢病药学服务提供范式参考。
      方法 采用六西格玛管理法创新框架保障儿童哮喘全病程药学服务功能设计的科学性、可持续性,借助数字化、智能化技术实现智慧审方、人工智能小程序智慧随访等具体药学服务功能,进而构建出儿童哮喘智慧药学服务并开展实践(设为观察组),通过与儿童哮喘传统药学服务(设为对照组)对比各随访阶段的患儿评价指标,验证其成效。
      结果 符合纳入标准患儿412例,其中对照组202例,观察组210例,各主要观察指标呈现时序差异性演变。第1次随访时,2组患儿的在访率、用药依从性评分、哮喘总控制率、3项肺功能指标差异均无统计学意义;观察组的控制类吸入装置掌握度评分显著高于对照组(P<0.01)。第2次随访时,观察组的在访率显著高于对照组(P<0.05);观察组的哮喘总控制率、3项肺功能指标均显著高于对照组(P<0.01)。第3次随访时,观察组的用药依从性评分显著高于对照组(P<0.01)。随访期间,观察组的药物不良反应实际发生率显著低于对照组(P<0.01),不良反应处置率显著高于对照组(P<0.01);观察组的服务满意度调查除隐私性与对照组差异无统计学意义,其余7项内容均显著高于对照组(P<0.01)。
      结论 随着研究时间的推移,儿童哮喘智慧药学服务相较儿童哮喘传统药学服务在访率、用药依从性、哮喘控制水平、肺功能指标、吸入装置掌握度、不良反应监护、服务满意度等方面逐渐体现出优势,有较好的应用前景。

       

      Abstract:
      OBJECTIVE This study aimed to construct a digital-intelligent empowered full-course pharmaceutical care model for pediatric asthma and validate its practical efficacy, so as to provide a referable paradigm for pharmaceutical services targeting children with chronic diseases.
      METHODS An innovative framework based on Six Sigma management methodology was adopted to ensure the scientific validity and sustainability of the functional design of full-course pharmaceutical care for pediatric asthma. Digital and intelligent technologies were utilized to realize core service functions, including intelligent prescription auditing and artificial intelligence mini-program-based dynamic follow-up. On this basis, a novel intelligent pharmaceutical care model for pediatric asthma was constructed and implemented, with enrolled children assigned to the observation group. To verify the efficacy of the model, evaluation indicators at each follow-up stage were compared between the observation group and the control group, which received traditional pharmaceutical care for pediatric asthma.
      RESULTS A total of 412 eligible children were enrolled in the study, including 202 cases in the control group and 210 cases in the observation group. All primary outcome indicators exhibited distinct temporal dynamic changes. At the first follow-up, no significant intergroup differences were observed in the follow-up retention rate, medication adherence score, overall asthma control rate, or three pulmonary function parameters. However, the observation group showed a significantly higher mastery score of controller inhalers than the control group(P<0.01). At the second follow-up, the observation group achieved a significantly higher follow-up retention rate(P<0.05), as well as superior overall asthma control rate and better pulmonary function indicators(P<0.01). At the third follow-up, the medication adherence score of the observation group was significantly higher than that of the control group(P<0.01). During the entire follow-up period, the observation group presented a significantly lower incidence of adverse drug reactions and a significantly higher rate of standardized adverse reaction management(P<0.01). In the service satisfaction evaluation, no significant difference was found in the privacy dimension between the two groups, while the observation group obtained significantly higher scores in the other seven evaluation dimensions(P<0.01).
      CONCLUSION With the extension of follow-up time, the digital-intelligent full-course intelligent pharmaceutical care model gradually presents comprehensive advantages over traditional pharmaceutical care in terms of follow-up retention, medication adherence, asthma control level, pulmonary function, inhaler technique proficiency, adverse reaction monitoring and disposal, and medical service satisfaction. This model has promising prospects for clinical popularization and application in pediatric chronic disease management.

       

    /

    返回文章
    返回