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本文引用的文献

1
Factors associated with exacerbation of heart failure include treatment adherence and health literacy skills.与心力衰竭加重相关的因素包括治疗依从性和健康素养技能。
Clin Pharmacol Ther. 2009 Jun;85(6):651-8. doi: 10.1038/clpt.2009.7. Epub 2009 Mar 4.
2
Factors affecting therapeutic compliance: A review from the patient's perspective.影响治疗依从性的因素:从患者角度的综述。
Ther Clin Risk Manag. 2008 Feb;4(1):269-86. doi: 10.2147/tcrm.s1458.
3
Objectively measured, but not self-reported, medication adherence independently predicts event-free survival in patients with heart failure.客观测量而非自我报告的药物依从性可独立预测心力衰竭患者的无事件生存期。
J Card Fail. 2008 Apr;14(3):203-10. doi: 10.1016/j.cardfail.2007.11.005.
4
Randomized clinical trial of a postdischarge pharmaceutical care program vs regular follow-up in patients with heart failure.心力衰竭患者出院后药物治疗护理计划与常规随访的随机临床试验。
Farm Hosp. 2006 Nov-Dec;30(6):328-42. doi: 10.1016/s1130-6343(06)74004-1.
5
Pharmaceutical care of patients with heart failure.心力衰竭患者的药学监护
Br J Clin Pharmacol. 2005 Aug;60(2):183-93. doi: 10.1111/j.1365-2125.2005.02387.x.
6
What do discharged patients know about their medication?出院患者对其用药情况了解多少?
Patient Educ Couns. 2005 Mar;56(3):276-82. doi: 10.1016/j.pec.2004.02.019.
7
Development and validation of the medication regimen complexity index.药物治疗方案复杂性指数的开发与验证。
Ann Pharmacother. 2004 Sep;38(9):1369-76. doi: 10.1345/aph.1D479. Epub 2004 Jul 20.
8
Mood stabilizers and treatment adherence in bipolar disorder: addressing adverse events.双相情感障碍中的心境稳定剂与治疗依从性:应对不良事件
Ann Clin Psychiatry. 2003 Sep-Dec;15(3-4):217-24. doi: 10.1023/b:acli.0000008175.32403.8e.
9
Prescribing and taking medicines.开药与服药。
BMJ. 2003 Oct 11;327(7419):819. doi: 10.1136/bmj.327.7419.819.
10
Pharmacist intervention program for control of hypertension.控制高血压的药剂师干预计划。
Ann Pharmacother. 2003 Sep;37(9):1186-93. doi: 10.1345/aph.1C267.

在以色列,药剂师在患者出院前对其进行咨询有助于提高患者的药物依从性,缩小差距,改善预后。

Pharmacist counseling to cardiac patients in Israel prior to discharge from hospital contribute to increasing patient's medication adherence closing gaps and improving outcomes.

机构信息

Department of Internal Medicine and Clinical Neuroscience, EMMS Nazareth-The Nazareth Hospital, Nazareth 16100, Israel.

出版信息

J Transl Med. 2012 Mar 1;10:34. doi: 10.1186/1479-5876-10-34.

DOI:10.1186/1479-5876-10-34
PMID:22380642
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3310721/
Abstract

BACKGROUND

Medication non adherence is a global epidemic perplexing phenomenon that is eminent, but not insurmountable. Our first objective was to explore whether providing pharmacist's counseling to cardiac patients prior to discharge can increase patient's medication adherence, and our second objective was to assess whether better medication adherence leads to reduction of hospital readmissions.

METHODS

Observational study was conducted among diagnosed cardiac patients using an intervention strategy at discharge from two hospitals in Israel; The Nazareth and the Haemek hospital. 74 patients were recruited between January 2010 and January 2011. Two separate groups were selected; intervention group: 33 patients who prior to discharge received nurse, pharmacist interventions, and control group: 41 patients who had received the nurse and hospital discharge counseling only.

RESULTS

Regression analysis for examining the first objective reflected significant effect when having a pharmacist interventions, which explains the increasing 11.6% of the variance in medication adherence, [F change (1,73) = 9.43, p < 0.003]. Stepwise regression analysis for examining the second objective demonstrated that the relation between medication adherence and readmissions was insignificant [F (1,73) = 9.43, n.s].

CONCLUSIONS

While physicians and nurses can have an impact on improving adherence, pharmacists have demonstrated the ability to inform, problem-solve and provide performance support directly to patients.

摘要

背景

药物不依从是一种全球性的、令人困扰的普遍现象,但并非不可逾越。我们的首要目标是探讨在患者出院前为其提供药师咨询服务是否可以提高患者的用药依从性,我们的第二个目标是评估更好的用药依从性是否会降低医院再入院率。

方法

在以色列的两家医院(拿撒勒医院和海马克医院)进行了一项观察性研究,采用出院干预策略对确诊的心脏病患者进行研究;2010 年 1 月至 2011 年 1 月期间共招募了 74 名患者。我们选择了两组患者:干预组(n=33)在出院前接受了护士和药师的干预,对照组(n=41)仅接受了护士和医院的出院咨询。

结果

检验第一个目标的回归分析反映了药师干预的显著效果,这解释了用药依从性增加了 11.6%的方差[F 变化(1,73)=9.43,p<0.003]。检验第二个目标的逐步回归分析表明,用药依从性与再入院率之间的关系并不显著[F(1,73)=9.43,n.s]。

结论

尽管医生和护士可以对提高患者的依从性产生影响,但药师已证明有能力向患者提供信息、解决问题和提供绩效支持。