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药剂师主导的慢性病门诊老年患者药物治疗管理的影响。

Impact of pharmacist-led medication therapy management in ambulatory elderly patients with chronic diseases.

机构信息

Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Br J Clin Pharmacol. 2021 Jul;87(7):2937-2944. doi: 10.1111/bcp.14709. Epub 2021 Jan 20.

Abstract

AIMS

This study aimed to assess the impact of pharmacist-led medication therapy management (MTM) performed on ambulatory elderly patients with chronic diseases.

METHODS

Patients who came to a pharmacist-led outpatient clinic between January 2016 and June 2018 were enrolled in this study. Eligible subjects received MTM services from the pharmacists at least twice a year and the clinical data of these patients were complete. Drug-related problems (DRPs) and recommendations were evaluated using The Pharmaceutical Care Network Europe Classification for Drug related problems V8.03.

RESULTS

A total of 525 DRPs were identified during the study period. Treatment effectiveness (53.71%) was the most common DRP. The most frequently recommended intervention was changing the drug (48.76%). There were 92.38% patients accepting the interventions and 90.48% patients completely implemented. The number of drugs taken was the significant associated factor for DRPs. Postintervention data collection showed lower levels in systolic blood pressure (BP) and diastolic BP compared to the preintervention data collection. There were statistically significant changes in total cholesterol, low-density lipoprotein cholesterol and triglycerides between the pre- and postintervention data collections. The average cost of medications per patient for every month decreased from 387.72 to 355.17 renminbi (P = .009).

CONCLUSION

We confirmed that pharmacists had a valuable role to perform MTM services for ambulatory elderly patients, not only in identifying and solving the DRPs, but also in improving clinical outcomes (BP and lipid level) and cost-saving effect.

摘要

目的

本研究旨在评估药剂师主导的药物治疗管理(MTM)对慢性病门诊老年患者的影响。

方法

本研究纳入了 2016 年 1 月至 2018 年 6 月期间在药剂师主导的门诊就诊的患者。符合条件的患者每年至少接受两次药剂师的 MTM 服务,且这些患者的临床数据完整。使用欧洲药物相关问题分类(Pharmaceutical Care Network Europe Classification for Drug related problems V8.03)评估药物相关问题(DRPs)和建议。

结果

在研究期间共发现 525 个 DRPs。治疗效果(53.71%)是最常见的 DRP。最常推荐的干预措施是更换药物(48.76%)。有 92.38%的患者接受了干预措施,90.48%的患者完全执行。服用药物的数量是 DRPs 的显著相关因素。干预后数据采集显示收缩压(BP)和舒张压均低于干预前数据采集。总胆固醇、低密度脂蛋白胆固醇和甘油三酯在干预前后数据采集之间有统计学显著变化。每位患者每月的药物费用从 387.72 人民币降至 355.17 人民币(P=.009)。

结论

我们证实,药剂师在为慢性病门诊老年患者提供 MTM 服务方面具有重要作用,不仅可以发现和解决 DRPs,还可以改善临床结局(BP 和血脂水平)和节省成本的效果。

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