Pai Amy Barton, Boyd Alex, Chavez Alicia, Manley Harold J
Albany College of Pharmacy and Health Sciences, New York, 12208, USA.
Hemodial Int. 2009 Jan;13(1):72-9. doi: 10.1111/j.1542-4758.2009.00328.x.
End-stage renal disease and initiation of hemodialysis (HD) adversely affect health-related quality of life (HRQOL). There are currently no data evaluating the effect of pharmaceutical care (PC) on HRQOL in HD patients. HD patients were randomized to receive PC; one-on-one, in-depth medication reviews conducted by a clinical pharmacist or Standard of Care (SOC); and brief medication reviews conducted by dialysis nurses. The renal quality of life profile (RQLP) was administered at baseline and then at 1 and 2 years after study initiation. The RQLP is a 43-item questionnaire that has 5 dimensions: Eating/Drinking, Physical Activities, Leisure Time, Psychosocial Activities, and Impact of Treatment, where increasing scores reflect worsening of HRQOL. A total of 107 patients were enrolled (SOC: n=46; PC: n=61). Besides gender, there were no differences in the demographics or the baseline total RQLP scores. The mean+/-SD total RQLP scores at Year 1 were significantly worse in SOC compared with PC (88+/-31 vs. 71+/-34, respectively; P=0.03). Significant worsening of Eating and Drinking (5.9+/-3.3 vs. 4.4+/-3.1, respectively; P=0.04), Physical Activities (37+/-13.6 vs. 30+/-16.3, respectively; P=0.04), and Leisure Time scores (8.3+/-3.4 vs. 5.9+/-3.6, respectively; P=0.03) was also observed in the SOC group. After 2 years, only the SOC patients had worsening of Leisure Time (7.5+/-3.0 vs. 5.2+/-3.9, respectively; P=0.04). No other parameters were different between the groups after 2 years. These data indicate that patients who have clinical care provided by pharmacists do not have worsened HRQOL after 1 year and are able to maintain HRQOL for an additional year.
终末期肾病和开始血液透析（HD）会对健康相关生活质量（HRQOL）产生不利影响。目前尚无数据评估药学服务（PC）对HD患者HRQOL的影响。HD患者被随机分组，分别接受PC（由临床药师进行一对一深入药物评估）或常规护理标准（SOC）（由透析护士进行简短药物评估）。在基线时以及研究开始后的1年和2年时进行肾脏生活质量概况（RQLP）评估。RQLP是一份包含43个条目的问卷，有5个维度：饮食、身体活动、休闲时间、心理社会活动以及治疗影响，得分增加反映HRQOL恶化。总共招募了107名患者（SOC组：n = 46；PC组：n = 61）。除性别外，两组在人口统计学特征或基线RQLP总分上无差异。与PC组相比，SOC组在第1年时RQLP总分的均值±标准差显著更差（分别为88±31和71±34；P = 0.03）。SOC组在饮食（分别为5.9±3.3和4.4±3.1；P = 0.04）、身体活动（分别为37±13.6和30±16.3；P = 0.04）以及休闲时间得分（分别为8.3±3.4和5.9±3.6；P = 0.03）方面也出现了显著恶化。2年后，只有SOC组患者的休闲时间得分恶化（分别为7.5±3.0和5.2±3.9；P = 0.04）。2年后两组之间的其他参数没有差异。这些数据表明，由药师提供临床护理的患者在1年后HRQOL没有恶化，并且能够在接下来的一年中维持HRQOL。
