临床药师参与慢性心力衰竭临床路径管理的效果评价
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篇名: | 临床药师参与慢性心力衰竭临床路径管理的效果评价 |
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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(P<0.05)。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(P<0.05);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(P>0.05)。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(P>0.05)。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(P<0.05);再入院率虽低于对照组,但差异无统计学意义(P>0.05)。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(P<0.05)。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 effects of clinical pharmacists participating in clinical pathway management for chronic heart failure (CHF). METHODS: A total of 107 CHF adult inpatients in Linyi People’s Hospital during Jan. 2014-Oct. 2015 were divided into control group (56 cases, 3 withdrawal, 53 in total) and trial group (58 cases, 4 withdrawal, 54 in total) according to random number table. Control group received routine clinical pathway management method of CHF; trial group received clinical pathway management with the participation of clinical pharmacists. Clinical efficacy, the utilization of heart failure drugs, economic indexes, medication compliance after discharge, re-hospitalization rate due to heart failure were compared between 2 groups. RESULTS: Total response rate of trial group was significantly higher than control group, with statistical significance (P<0.05). The utilization rate of ACEI/ARB, β-receptor blocker, target dose rate of ACEI/ARB in trial group were significantly higher than control group, with statistical significance (P<0.05); target dose rate of β-receptor blocker was higher than control group, without statistical significance (P>0.05). Hospitalization time, drug cost, total hospitalization cost and drug ratio of trial group were shorter or lower than control group, without statistical significance (P>0.05). One month after discharge, the proportion of medication compliance in trial group was significantly higher than control group, with statistical significance (P<0.05); re-hospitalization rate was lower than control group, without statistical significance (P>0.05). Three months after discharge, the proportion of medication compliance in trial group was higher than control group, while re-hospitalization rate was lower than control group, with statistical significance (P<0.05). CONCIUSIONS: The participation of clinical pharmacists in clinical pathway management of CHF can significantly improve the utilization rate of recommended drugs by guideline, clinical efficacy and medication compliance, and reduce re-hospitalization rate. |
期刊: | 2017年第28卷第23期 |
作者: | 潘金,刘梅霞,车峰远,李峥嵘,张宗林,石增成,欧知宏 |
AUTHORS: | PAN Jin,LIU Meixia,CHE Fengyuan,LI Zhengrong,ZHANG Zonglin,SHI Zengcheng,OU Zhihong |
关键字: | 慢性心力衰竭;临床路径;临床药师;药学服务 |
KEYWORDS: | Chronic heart failure; Clinical pathway; Clinical pharmacist; Pharmaceutical care |
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