Pharmacy Department, Chi Mei Medical Center, Tainan, Taiwan.
Clin Drug Investig. 2004;24(10):603-9. doi: 10.2165/00044011-200424100-00006.
To assess the economic and humanistic outcomes of clinical pharmacist interventions for patients with asthma and to assess the effect on patients' quality of life.
A prospective cohort study was conducted at a medical centre in southern Taiwan.
Seventy patients with moderate to severe asthma were enrolled in the study from July 2003 to December 2003. Patients who were 17-53 years of age and were attending the outpatient clinic were referred to the pharmacist intervention programme. Patients were educated about their disease, pharmacotherapy, self-management and inhalation and peak flow meter techniques to use during the intervention period. A modified Asthma Quality-of-Life Questionnaire (AQLQ) was given to the patients at the first intervention (baseline) and 3 months later (intervention period) to assess quality of life. An asthma general knowledge questionnaire and an asthma diary chart were also used to assess patients' knowledge about asthma and the improvement in their symptoms. The cost effectiveness was evaluated based on the reduction in total costs/mean cost at each visit.
Of the 70 asthmatic patients enrolled in the study; 55 completed the questionnaires at baseline and after the intervention period. Only 25 of 55 (45.5%) patients completed the asthma diary chart. After the pharmacist intervention period, the patients' quality of life, common knowledge about asthma, and peak expiratory flow rate (PEFR) were significantly improved as compared with baseline (p < 0.001). The frequency of use of beta(2)-agonists and corticosteroids were also reduced, although the reduction was not statistically significant. Total cost per patient at baseline was statistically different from that after the 3-month intervention period (New Taiwanese dollars [$NT] 2880 vs $NT1683, respectively; costings are costs during the study period).
For patients with moderate to severe asthma, pharmacist intervention can be a cost-effective addition to the management of patients at an outpatient clinic by improving PEFR and patient quality of life, and saving medical resources.
评估临床药师干预对哮喘患者的经济学和人文结局，并评估其对患者生活质量的影响。
在台湾南部的一家医疗中心进行了一项前瞻性队列研究。
2003 年 7 月至 2003 年 12 月期间，共纳入 70 名中重度哮喘患者。17-53 岁、在门诊就诊的患者被转介到药师干预项目。在干预期间，对患者进行疾病、药物治疗、自我管理以及吸入和峰流速仪技术方面的教育。在第一次干预（基线）和 3 个月后（干预期），使用改良哮喘生活质量问卷（AQLQ）评估患者的生活质量。还使用哮喘一般知识问卷和哮喘日记图表评估患者对哮喘的了解程度以及症状的改善情况。基于每次就诊的总成本/平均成本降低情况，评估成本效益。
70 名哮喘患者中，有 55 名完成了基线和干预后阶段的问卷调查。仅有 25 名（45.5%）患者完成了哮喘日记图表。经过药师干预后，与基线相比，患者的生活质量、对哮喘的一般了解以及呼气峰流速率（PEFR）均有显著改善（p < 0.001）。β2-激动剂和皮质激素的使用频率也有所降低，但降低幅度无统计学意义。患者基线时的每位患者总成本与 3 个月干预后的总成本存在统计学差异（新台币 2880 元比 1683 元；成本为研究期间的成本）。
对于中重度哮喘患者，药师干预可通过改善 PEFR 和患者生活质量，节约医疗资源，成为门诊患者管理的一种具有成本效益的附加手段。
