药学服务对囊性纤维化患者药物依从性的影响。
Impact of pharmacy services on cystic fibrosis medication adherence.
作者信息
Zobell Jeffery T, Schwab Elizabeth, Collingridge Dave S, Ball Cody, Nohavec Robert, Asfour Fadi
机构信息
Pharmacy, Intermountain Primary Children's Hospital, Salt Lake City, Utah.
Intermountain Cystic Fibrosis Pediatric Center, Salt Lake City, Utah.
出版信息
Pediatr Pulmonol. 2017 Aug;52(8):1006-1012. doi: 10.1002/ppul.23743. Epub 2017 Jun 13.
OBJECTIVES
The purpose of this study is to characterize the impact of pharmacy services on medication adherence and hospitalizations for pediatric cystic fibrosis (CF) patients.
METHODS
A retrospective health insurance claims analysis and patient medical charts review from January 1, 2014 to December 31, 2016 of patients from the Pediatric Intermountain CF Center was performed. Adherence to dornase alfa and hospital admissions for pulmonary exacerbations pre and post the implementation of an integrated pharmacy team were reviewed. Dornase alfa adherence was measured by the medication possession ratio (MPR) both monthly and yearly.
RESULTS
Fifty-four patients met inclusion criteria. The mean dornase alfa yearly MPR improved from 0.75 (2014) to 0.92 (2016). Patients were 2.8 times more likely to be adherent to dornase alfa when followed by integrated pharmacy team model (P < 0.001), and 2.4 times more likely to be adherent when followed by a dedicated CF clinic pharmacist only (P = 0.001).
CONCLUSION
The study demonstrated that pharmacy services improved adherence to dornase alfa.
目的
本研究旨在描述药学服务对小儿囊性纤维化（CF）患者药物依从性和住院情况的影响。
方法
对山间儿科CF中心2014年1月1日至2016年12月31日患者的健康保险理赔进行回顾性分析，并查阅患者病历。回顾了在综合药学团队实施前后，患者对 Dornase alfa 的依从性以及因肺部病情加重而住院的情况。通过药物持有率（MPR）按月和按年衡量Dornase alfa的依从性。
结果
54名患者符合纳入标准。Dornase alfa的年平均MPR从2014年的0.75提高到2016年的0.92。在综合药学团队模式下接受随访的患者坚持使用Dornase alfa的可能性是原来的2.8倍（P < 0.001），仅在由专门的CF诊所药剂师随访时，坚持使用的可能性是原来的2.4倍（P = 0.001）。
结论
该研究表明药学服务提高了对Dornase alfa的依从性。
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