| 张楠,夏文斌,闫阔,蔡泓敏,杨慧鹃,陈思音,尤秀梅,皮林.分级诊疗模式下医联体药师参与高血压患者长期药学监护工作实践[J].中国药事,2021,35(12):1441-1448 |
| 分级诊疗模式下医联体药师参与高血压患者长期药学监护工作实践 |
| On Participation of Medical Consortium Pharmacists in Long-term Pharmaceutical Care for Hypertensive Patients under Graded Diagnosis & Treatment Mode |
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| DOI：10.16153/j.1002-7777.2021.12.017 |
| 中文关键词: 药学监护 高血压 医联体 慢病管理 用药安全 |
| 英文关键词: pharmaceutical care hypertension medical consortium chronic disease management medication safety |
| 基金项目:北京市科技计划首都临床特色应用研究(编号 Z181100001718125) |
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| 中文摘要: |
| 目的：通过医联体药师参与高血压患者长期药学监护工作的探索实践，为分级诊疗模式下实现医联体连续性药学服务提供经验参考。方法：选取2019年5月16日至6月30日在北京市垂杨柳医院就诊且符合入选标准的135例住院患者为研究对象，由我院临床药师带动指导社区药师共同参与，综合借鉴国内外先进管理经验和工作规范，对患者进行住院期间、出院后转诊至社区诊疗及居家康复期间的长期连续性药学监护，进行药物整合、用药风险评估、用药合理性评估、用药教育与长期随访等，并实施用药风险分级管理，制定高血压患者长期药学监护技术手册，建立长期药学监护管理数据库。结果：该工作模式运行6个月，与干预前对照，高风险组和低风险组患者安全用药认知能力评分、用药依从性评分、 患者血压达标率均有显著提高，药师对不合理处方的有效辨识率和干预率显著提高，以上差异均具有统计学意义(P＜0.05)。结论：医联体药师参与高血压患者长期药学监护工作对于提升患者用药认知能力及用药依从性、提高患者血压达标率具有重要作用，同时也有助于提升药师对临床不合理用药的辨识和干预能力。 |
| 英文摘要: |
| Objective: Through the practice of medical consortium pharmacists participating in the longterm pharmaceutical care for hypertensive patients, we aim to provide experience for realizing continuous pharmaceutical care under graded diagnosis and treatment mode. Methods: A total of 135 inpatients with hypertension in Beijing Chuiyangliu Hospital from May16th to June 30th, 2019 were selected as research subjects. The clinical pharmacists in our hospital led and guided the community pharmacists to participate in the longterm continuous pharmaceutical care for patients during hospitalization, community diagnosis and treatment after discharge from hospital and home rehabilitation through comprehensive use of advanced management experienceand work norms at home and abroad. Drug integration, medication risk assessment, rationality assessment of drug use, medication education and long-term follow-up visits were carried out. Medication risk management was graded, technical manuals of long-term pharmaceutical care for hypertensive patients were implemented, and a the management database of a long-term pharmaceutical care was established. Results: This work model has been running for 6 months. Compared with those before intervention, those before intervention, in the highrisk group and the low-risk group were significantly improved. The pharmacists' effective recognition rate and intervention rate of unreasonable prescriptions were increased significantly, and the above differences were statistically significant (P＜0.05). Conclusions: The participation of medical consortium pharmacists in long-term pharmaceutical care for hypertensive patients plays an important role in improving patients' cognitive ability, medication compliance, and blood pressure compliance, as well as in enhancing pharmacists' ability to identify and intervene in clinically irrational medication. |
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