哮喘、慢性阻塞性肺疾病患者分级药学服务的实施与临床评价

发布时间：2018-04-29 22:09

本文选题：哮喘 + 慢性阻塞性肺疾病　；参考：《中国药学杂志》2017年16期

【摘要】：目的探讨药师为哮喘和慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者提供分级药学服务的模式。方法以我院哮喘和COPD患者为研究对象,结合哮喘和COPD临床指南,制定分级药学服务标准。收集患者256例,随机分成干预组和对照组,根据分级标准对患者实施不同级别的药学服务。将两组患者干预前、干预3个月后、干预6个月后的分级评分、用药依从性和肺功能指标(FEV1/FVC、FEV1%预计值)进行两组间的比较,观察不良反应发生情况,急性加重发作次数大于等于已发生情况以及临床有效控制率。结果与对照组相比,干预6个月后,干预组一级服务比例下降了25%;不良反应发生率减少了7.82%;急性加重次数大于等于发生率降低了7.81%;临床有效控制率提高了23.43%;FEV1/FVC、FEV1%预计值和用药依从性得到显著改善,差异具有统计学意义(P0.05)。结论通过对哮喘和COPD慢性病患者实施分级药学服务,可以帮助药师在最短的时间内找到需要重点服务的对象,同时达到提高药学服务质量和临床疗效的目的。
[Abstract]:Objective to explore the model of pharmacists providing graded pharmacological care for patients with asthma and chronic obstructive pulmonary disease (CPD). Methods the patients with asthma and COPD in our hospital were studied, and the standard of graded pharmacological care was established in combination with the clinical guidelines of asthma and COPD. 256 patients were randomly divided into intervention group and control group. Before intervention, 3 months after intervention, 6 months after intervention, grading score, compliance and pulmonary function index were compared between the two groups to observe the occurrence of adverse reactions, and to compare the FEV1 / FVC+ FEV1% predicted values between the two groups. The number of acute exacerbations was greater than that of the occurrence and the effective clinical control rate. Results compared with the control group, after 6 months of intervention, The proportion of first-level services in the intervention group decreased by 25%; the incidence of adverse reactions was reduced by 7.82; the incidence of acute exacerbation was equal to that of the incidence rate by 7.81; the effective clinical control rate increased by 23.43% FEV1 / FVCFEV1% and the drug compliance was significantly improved. The difference was statistically significant (P 0.05). Conclusion graded pharmacological care for patients with chronic diseases of asthma and COPD can help pharmacists to find the most important services in the shortest time, and to improve the quality of pharmaceutical care and the clinical efficacy at the same time.
【作者单位】：苏州大学附属第一医院药学部;
【基金】：国家自然科学基金资助项目(81300026) 江苏省卫生计生委预防医学科研课题项目资助(Y2015068) 苏州市科技局应用基础研究医疗卫生项目资助(SYS201541);苏州市科技局常州四药项目资助(SYSD2016147) 百特生物药学基金课题资助项目资助(201514)
【分类号】：R562.25;R563.9

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