临床药师参与慢性心力衰竭临床路径管理的效果评价

发布时间：2018-08-26 13:33

【摘要】：目的:评价临床药师参与慢性心力衰竭临床路径管理的作用和效果。方法:选取2014年1月-2015年10月临沂市人民医院心内科收治的107例成人慢性心力衰竭住院患者,按照随机数字表法分为对照组(56例,脱落3例,共53例完成研究)和试验组(58例,脱落4例,共54例完成研究),对照组采用常规慢性心力衰竭临床路径管理方法,试验组采用临床药师参与的临床路径管理方法。比较两组患者的临床疗效、心衰药物使用情况、经济学指标、出院后用药依从性及因心衰再入院率等。结果:试验组患者临床总有效率显著高于对照组,差异有统计学意义(P0.05)。试验组患者血管紧张素转化酶抑制药(ACEI)/血管紧张素受体阻滞药(ARB)、β受体阻滞药的使用率与AECI/ARB的靶剂量率均显著高于对照组,差异有统计学意义(P0.05);而β受体阻滞药的靶剂量率虽高于对照组,但差异无统计学意义(P0.05)。试验组患者住院时间、药品费用、总住院费用、药占比均低于或低于对照组,但差异均无统计学意义(P0.05)。出院1个月后,试验组患者服药依从率显著高于对照组,差异有统计学意义(P0.05);再入院率虽低于对照组,但差异无统计学意义(P0.05)。出院3个月后,试验组患者服药依从率显著高于对照组,再入院率低于对照组,差异均有统计学意义(P0.05)。结论:临床药师参与慢性心力衰竭临床路径管理,可以明显提高指南推荐药物的使用率、临床疗效及患者用药依从性,降低再入院率。
[Abstract]:Objective: to evaluate the role and effect of clinical pharmacists in clinical pathway management of chronic heart failure (CHF). Methods: 107 adult patients with chronic heart failure admitted in Department of Cardiology, Linyi people's Hospital from January 2014 to October 2015, were randomly divided into control group (56 cases) and experimental group (58 cases). The control group was treated with routine clinical pathway management for chronic heart failure and the experimental group was treated with clinical pathway management with the participation of clinical pharmacists. The clinical efficacy, drug use, economic indicators, drug compliance and readmission rate of CHF were compared between the two groups. Results: the total clinical effective rate of the trial group was significantly higher than that of the control group, the difference was statistically significant (P0.05). The usage rate of angiotensin converting enzyme inhibitor (ACEI) / angiotensin receptor blocker (ARB), 尾) and the target dose rate of AECI/ARB in the trial group were significantly higher than those in the control group. The difference was statistically significant (P0.05), while the target dose rate of 尾 receptor blockers was higher than that of the control group, but the difference was not statistically significant (P0.05). The hospitalization time, drug cost, total hospitalization cost and the proportion of drug in the trial group were lower than or lower than those in the control group, but the difference was not statistically significant (P0.05). One month after discharge, the compliance rate of patients in the trial group was significantly higher than that in the control group (P0.05); the readmission rate was lower than that in the control group, but the difference was not statistically significant (P0.05). Three months after discharge, the compliance rate of patients in the trial group was significantly higher than that in the control group, and the readmission rate was lower than that in the control group (P0.05). Conclusion: the clinical pharmacists' involvement in the clinical path management of chronic heart failure can significantly improve the utilization rate of the recommended drugs, clinical efficacy and compliance of patients with chronic heart failure, and reduce the readmission rate.
【作者单位】：临沂市人民医院心内科;临沂市中医医院药剂科;临沂市人民医院神经内科;临沂市人民医院药学部;
【基金】：山东省科技惠民计划项目(No.2013kjhm130406) 山东省医药卫生科技发展计划项目(No.2015WS0367)
【分类号】：R541.6

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