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[基于CMO模型的药物干预对风湿病患者生物药物依从性的影响及经验(AdhER-2研究)]

[Effectiveness on adherence to biological drugs and experience of a pharmaceutical intervention based on CMO model in patients with rheumatic disease (AdhER-2 study)].

作者信息

Caso-González A, Núñez-Rodríguez J, González-Pérez Y, Leralta-González C, Sanz-Alonso V, Obaldia-Alaña C

机构信息

Servicio de Farmacia. Hospital San Pedro. Logroño (La Rioja). España.

出版信息

An Sist Sanit Navar. 2022 Aug 16;45(2):e1004. doi: 10.23938/ASSN.1004.

Abstract

BACKGROUND

We aimed to assess the effectiveness on adherence to treatment with biologic disease modifying anti-rheumatic drugs (b-DMARD) and experience with providers of healthcare of a CMO pharmaceutical intervention care model in subjects with rheu-matoid arthritis, psoriatic arthritis, and ankylosing spondylitis stratified according to their needs.

METHOD

Prospective, single-centre randomized controlled study. The study period was eleven months. Non-compliant patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondy-litis treated with b-DMARD were included. Patients were randomized to a control (CG) or intervention group (IG) who received regular or the CMO pharmaceutical intervention model treatment, respec-tively. Baseline and final adherence were determined using medication possession ratio, the Compliance Questionnaire on Rheu-matology, and Morisky Medication Adherence Scale. To assess baseline and final patient experience with providers of healthcare we applied the Chronic Patient Experience Assessment Instrument (IEXPAC).

RESULTS

For the IG, one patient (5.6%) was categorized as priority 1, nine (50.0%) as priority 2, and eight (44.4%) as priority 3. Ninety pharmaceutical interventions were carried out (5.1±1.8 interventions / patient). At the end of the study, the IG showed higher fre-quency of patients who adhered to the pharmaceutical intervention (77.8 vs 18.8%; p=0.002) and higher mean IEXPAC score (7.6±1.3 vs 5.8±1.1; p <0.001) in comparison to the CG. Conclusion The CMO pharmaceutical intervention model significantly improves patient adherence to b-DMARD and their experience with the providers of healthcare.

摘要

背景

我们旨在评估一种首席医疗官(CMO)药物干预护理模式对类风湿关节炎、银屑病关节炎和强直性脊柱炎患者使用生物改善病情抗风湿药物(b-DMARD)治疗依从性的有效性,以及根据患者需求分层后其在医疗服务提供者方面的体验。

方法

前瞻性、单中心随机对照研究。研究期为11个月。纳入使用b-DMARD治疗的类风湿关节炎、银屑病关节炎和强直性脊柱炎的不依从患者。患者被随机分为对照组(CG)或干预组(IG),分别接受常规治疗或CMO药物干预模式治疗。使用药物持有率、风湿病依从性问卷和Morisky药物依从性量表确定基线和最终依从性。为评估患者在医疗服务提供者方面的基线和最终体验,我们应用了慢性病患者体验评估工具(IEXPAC)。

结果

对于干预组,1例患者(5.6%)被归类为1级优先,9例(50.0%)为2级优先,8例(44.4%)为3级优先。共进行了90次药物干预(5.1±1.8次干预/患者)。研究结束时,与对照组相比,干预组坚持药物干预的患者频率更高(77.8%对18.8%;p=0.002),IEXPAC平均得分更高(7.6±1.3对5.8±1.1;p<0.001)。结论CMO药物干预模式显著提高了患者对b-DMARD的依从性及其在医疗服务提供者方面的体验。

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