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药师干预可提高农村老年华法林使用者的健康相关生活质量:一项随机对照试验。

Pharmacists' interventions improve health-related quality of life of rural older person on warfarin: a randomized controlled trial.

机构信息

Pharmacy Branka Marušić, Trg Ante Starčevića 24, 31450, Donji Miholjac, Croatia.

Hematology Department, University Hospital Dubrava, Avenija Gojka Suska 6, 10000, Zagreb, Croatia.

出版信息

Sci Rep. 2021 Nov 9;11(1):21897. doi: 10.1038/s41598-021-01394-0.

Abstract

Warfarin therapy can significantly affect patients' quality of life and cause therapy discontinuation. This study aimed to investigate the effect of the pharmacists' interventions on the health-related quality of life (HRQoL) in older rural patients on warfarin therapy. Eligible older patients from rural area of Croatian province Slavonia were randomized into the intervention and control groups and followed for six months. Repeated education and a follow-up plan were provided to the participants in the intervention group, and if needed, the pharmacist intervened to optimize warfarin therapy. Secondary analysis on HRQoL data are presented here. Main outcome measure was Duke anticoagulation satisfactions scale questionnaire score. In total, 131 participants finished the study (median age 73 years; 51.1% male). Participants in the intervention group scored significantly lower (median being 86.5 and 66.0 in the control and intervention groups, respectively; p < 0,001), indicating higher HRQoL. Adverse drug reactions and pharmacist's intervention were identified as predictive factors for patients' HRQoL (r = 65.5%, P < 0.001). The study demonstrated that community pharmacist's interventions can improve HRQoL of older patients taking warfarin what is of particular significance for patients living in rural areas with less accessible healthcare and lower socio-economic status.Clinicaltrials.gov (ID: NCT03212898), 11/07/2017, retrospectively registered.

摘要

华法林治疗可能会显著影响患者的生活质量并导致治疗中断。本研究旨在调查药师干预对农村老年华法林治疗患者健康相关生活质量(HRQoL)的影响。符合条件的农村地区患者被随机分为干预组和对照组,并随访 6 个月。对干预组患者进行了重复教育和随访计划,如果需要,药剂师会进行干预以优化华法林治疗。此处呈现 HRQoL 数据的二次分析。主要观察指标是杜克抗凝满意度量表问卷评分。共有 131 名参与者完成了研究(中位数年龄 73 岁;51.1%为男性)。干预组的参与者评分明显更低(中位数分别为对照组和干预组的 86.5 和 66.0;p<0.001),表明 HRQoL 更高。药物不良反应和药剂师的干预被确定为患者 HRQoL 的预测因素(r=65.5%,P<0.001)。该研究表明,社区药师的干预可以改善服用华法林的老年患者的 HRQoL,这对于医疗资源较少且社会经济地位较低的农村地区的患者尤为重要。Clinicaltrials.gov(ID:NCT03212898),2017 年 7 月 11 日,回顾性注册。

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