Tang Zhao-Qi, Jiang Rui-Hua, Xu Hong-Bin
Department of Pharmacy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Clinic and Research Center of Tuberculosis, Shanghai Key Lab of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
J Clin Pharm Ther. 2018 Dec;43(6):888-894. doi: 10.1111/jcpt.12746. Epub 2018 Jul 12.
In this study, the effectiveness of pharmaceutical care on treatment outcomes for patients with first-time pulmonary tuberculosis in China was assessed.
In this study, patients were randomized either to the usual care (UC) group (n = 72) where patients received routine medical and nursing care or to the pharmaceutical care (PC) group (n = 59) where patients were simultaneously provided with pharmaceutical care. The primary objectives were to evaluate whether treatment outcomes and patient adherence improved more in the PC group than in the UC group. In addition, in PC group, outcomes included the number of patient-reported pharmaceutical care issues and pharmacists' interventions.
As compared to the UC group, treatment success rate was improved in the PC group, but the difference was not statistically significant (71% vs 54%; P = 0.137). However, as compared to the UC group, the number of patients who attended all of the scheduled visits was higher in the PC group; the difference was statistically significant (81% vs 60%, P = 0.018). Furthermore, the number of patients who had positive test results for all of the isoniazid tests was higher in the PC group than in the UC group; the difference was also statistically significant (80% vs 50%, P = 0.002). The consumed medication rate was improved in the PC group, but no significant difference was found between the two groups. The patient-reported pharmaceutical care issues mainly included dermatological, gastrointestinal, hepatic, metabolic, sensory, central nervous system and haematological problems. On the basis of clinical examination, laboratory parameters and drug information database, the pharmacists addressed most of these pharmaceutical care issues.
Pharmaceutical care might improve patient adherence for patients with first-time pulmonary tuberculosis in China, and further, rigorously controlled trials are required.
本研究评估了药学服务对中国初治肺结核患者治疗结局的有效性。
本研究中，患者被随机分为常规护理（UC）组（n = 72），该组患者接受常规医疗和护理，以及药学服务（PC）组（n = 59），该组患者同时接受药学服务。主要目的是评估PC组的治疗结局和患者依从性是否比UC组改善得更多。此外，在PC组中，结局包括患者报告的药学服务问题数量和药师的干预措施。
与UC组相比，PC组的治疗成功率有所提高，但差异无统计学意义（71%对54%；P = 0.137）。然而，与UC组相比PC组中按计划就诊的患者数量更多；差异有统计学意义（81%对60%，P = 0.018）。此外，PC组中异烟肼检测结果均为阳性的患者数量高于UC组；差异也有统计学意义（80%对50%，P = 0.002）。PC组的用药消耗率有所提高，但两组之间未发现显著差异。患者报告的药学服务问题主要包括皮肤、胃肠、肝脏、代谢、感觉、中枢神经系统和血液学问题。基于临床检查、实验室参数和药物信息数据库，药师解决了大多数这些药学服务问题。
药学服务可能会提高中国初治肺结核患者的依从性，此外，还需要进行严格对照试验。
