Bucci Claudia, Jackevicius Cynthia, McFarlane Karen, Liu Peter
The University Health Network, Toronto General Hospital, Toronto, Canada.
Can J Cardiol. 2003 Mar 31;19(4):391-6.
It has been cited that the management of congestive heart failure (CHF) requires a multidisciplinary approach; however, the role of the pharmacist has not been extensively studied. The roles for pharmacists are changing to meet the long term needs of patients in the community setting, including patients with CHF.
To evaluate the effect of a pharmacist on the appropriateness of medications taken by patients in the heart function clinic using the Medication Appropriateness Index (MAI) and to measure the effect of a pharmacist on the patients' response to the pharmacist's interventions using the Purdue Directive Guidance (DG) scale.
Eighty patients attending the heart function clinic at The University Health Network, Toronto General Hospital Toronto, Ontario were randomly assigned to an intervention group that received pharmacist services or a nonintervention group that received usual care from the clinic staff. Patients were assessed at baseline and at one-month follow-up.
The change in MAI score from baseline was 0.74 and 0.49 for the intervention and nonintervention groups, respectively (P=0.605). The change in DG survey results was 9.97 and 1.00 for the intervention and nonintervention groups, respectively (P<0.001). The intervention group improved significantly in all components of the DG survey, especially those pertaining to feedback and goal setting.
A benefit was demonstrated for 'directive guidance' of patients, in the form of education and goal setting as shown by positive survey results.
已有文献指出，充血性心力衰竭（CHF）的管理需要多学科方法；然而，药剂师的作用尚未得到广泛研究。药剂师的角色正在发生变化，以满足社区环境中患者的长期需求，包括CHF患者。
使用药物适宜性指数（MAI）评估药剂师对心脏功能门诊患者用药适宜性的影响，并使用普渡指导指南（DG）量表衡量药剂师对患者对其干预措施反应的影响。
安大略省多伦多市多伦多综合医院大学健康网络心脏功能门诊的80名患者被随机分配到接受药剂师服务的干预组或接受门诊工作人员常规护理的非干预组。在基线和随访1个月时对患者进行评估。
干预组和非干预组MAI评分从基线的变化分别为0.74和0.49（P = 0.605）。干预组和非干预组DG调查结果的变化分别为9.97和1.00（P<0.001）。干预组在DG调查的所有组成部分中均有显著改善，尤其是与反馈和目标设定相关的部分。
如积极的调查结果所示通过教育和目标设定的形式，证明了对患者进行“指导指南”的益处。
