Yumino Dai
Yumino Heart Clinic.
Yakugaku Zasshi. 2016;136(8):1133-6. doi: 10.1248/yakushi.15-00271-5.
As heart failure progresses to the end stage, it becomes more difficult to maintain the same level of quality of life using the established therapy for the heart failure patients. We believe that an innovative home medical care for heart failure therapy that focuses on the individual's quality of daily living and early intervention is necessary. The roles of home medical care include: early discharge to home as opposed to long hospitalization; the prevention of re-hospitalization; the provision of good care; treatment of any exacerbations; and options available at the end of the patient's life at home. Being able to provide all of the above will allow heart failure patients to live at their home. Home medical care for heart failure requires collaborative teamwork among multiple institutions and medical professionals. Among this collaborative group, the role of pharmacists is critical. Since many of the elderly with heart failure are taking multiple medications, it is important to evaluate the compliance and to intervene for improvement. Pharmacists visiting the patient's home will be able to check the patient's living environment, to evaluate medication compliance, to reconsider the necessary medications for the specific patient, and to consult physicians. Pharmacists can also explain clearly to patients and their family members any changes in medical therapy, as the conditions for an end-stage heart failure patient may change drastically in a short time. By achieving all of the above, it may be possible to prevent re-hospitalization and to help maintain the quality of life for heart failure patients.
随着心力衰竭发展到终末期,使用既定的心力衰竭治疗方法来维持相同水平的生活质量变得愈发困难。我们认为,一种专注于个人日常生活质量和早期干预的创新型心力衰竭居家医疗护理是必要的。居家医疗护理的作用包括:与长期住院相反,尽早出院回家;预防再次住院;提供优质护理;治疗任何病情加重情况;以及在患者生命末期在家中提供多种选择。能够提供上述所有内容将使心力衰竭患者能够在家中生活。心力衰竭居家医疗护理需要多个机构和医疗专业人员之间的协作团队合作。在这个协作团队中,药剂师的作用至关重要。由于许多老年心力衰竭患者正在服用多种药物,评估依从性并进行干预以改善情况非常重要。上门访视患者家庭的药剂师将能够检查患者的生活环境,评估用药依从性,重新考虑特定患者所需的药物,并与医生进行咨询。药剂师还可以向患者及其家属清楚解释医疗治疗的任何变化,因为终末期心力衰竭患者的病情可能在短时间内急剧变化。通过实现上述所有目标,有可能预防再次住院并帮助维持心力衰竭患者的生活质量。