提高肝移植受者药物依从性的系统性药学教育方法。

Systematic Pharmaceutical Educational Approach to Enhance Drug Adherence in Liver Transplant Recipients.

作者信息

Asavakarn S, Sirivatanauksorn Y, Promraj R, Ruenrom A, Limsrichamrern S, Kositamongkol P, Mahawithitwong P, Tovikkai C, Dumronggittigule W

机构信息

Hepatopancreatobiliary and Transplant Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Transplant Proc. 2016 May;48(4):1202-7. doi: 10.1016/j.transproceed.2015.12.100.

DOI:10.1016/j.transproceed.2015.12.100

PMID:27320587

Abstract

BACKGROUND

Drug adherence is one of the most important factors determining graft and patient survivals after liver transplantation. A systematic pharmaceutical educational approach has been implemented to improve adherence in immunosuppressive drugs therapy at Siriraj Hospital.

METHODS

This study was a single-center cross-sectional study of liver transplant patients who received pharmaceutical care from transplant pharmacists. The clinical pharmacy services, including medication review to emphasize patients' knowledge and awareness of immunosuppressive and general drug therapies with the use of various tools, were used to educate the patients. Drug-related problems (DRPs) and pre- and post-transplantation educational tests (divided into 3 parts: immunosuppressants [12 points], drug monitoring [6 points], and general drugs [2 points]) were analyzed.

RESULTS

From October 2012 to September 2014, a total of 50 liver transplant recipients (86 visits) were enrolled. After the systematic pharmaceutical educational program, the average total score of post-transplantation educational test improved from 3.48 to 13.30 (P < .001). Likewise, the mean scores of all 3 parts significantly increased (part I: 2.28 vs 8.18 [P < .001]; part II: 0.75 vs 3.63 (P < .001); and part III: 0.46 vs 1.50 [P < .001]). The incidences of major DRPs, nonadherence, and adverse drug reactions were 8%, 4%, and 2%, respectively.

CONCLUSIONS

A systematic pharmaceutical educational approach can significantly improve patients' knowledge and awareness concerning immunosuppressive drug usage.

摘要

背景

药物依从性是决定肝移植后移植物和患者存活的最重要因素之一。诗里拉吉医院已实施系统的药学教育方法以提高免疫抑制药物治疗的依从性。

方法

本研究是一项对接受移植药师药学服务的肝移植患者进行的单中心横断面研究。临床药学服务，包括使用各种工具进行用药审查以强化患者对免疫抑制和常规药物治疗的知识与意识，用于对患者进行教育。分析了药物相关问题（DRP）以及移植前后的教育测试（分为3部分：免疫抑制剂[12分]、药物监测[6分]和常规药物[2分]）。

结果

2012年10月至2014年9月，共纳入50例肝移植受者（86次就诊）。在系统的药学教育项目实施后，移植后教育测试的平均总分从3.48提高到13.30（P <.001）。同样，所有3部分的平均分均显著提高（第一部分：2.28对8.18 [P <.001]；第二部分：0.75对3.63 [P <.001]；第三部分：0.46对1.50 [P <.001]）。主要DRP、不依从和药物不良反应的发生率分别为8%、4%和2%。