药物治疗管理服务对血液透析患者药物负担生活质量的影响。
Effect of medication therapy management services on medication-burden quality of life in hemodialysis patients.
机构信息
Internal Medicine department, Nephrology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Clinical Pharmacy and Pharmacy Practice department, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
出版信息
BMC Nephrol. 2023 Sep 20;24(1):277. doi: 10.1186/s12882-023-03332-w.
BACKGROUND
Hemodialysis (HD) patients commonly receive polypharmacy leading to increased likelihood of drug related problems (DRPs) and poor quality of life. Medication Therapy Management (MTM) services discover and resolve DRPs and may specifically improve Medication-burden Quality of life (MBQoL) in HD patients. We aimed to assess the effect of MTM services on DRPs and MBQoL among HD patients.
METHODS
A prospective pre-post study was conducted on 104 patients in an HD unit in Alexandria, Egypt. MBQoL was assessed at baseline and after three months of MTM sessions, using the Arabic, validated version of the Patient Reported Outcomes Measure of Pharmaceutical Therapy (PROMPT) questionnaire. Cohen's d test and multiple linear regression were used to assess the effect size of MTM and the factors affecting MBQoL, respectively. DRPs, adverse events and adherence were also monitored.
RESULTS
MBQoL improved significantly after the implementation of MTM (Cohen's d=0.88, p < 0.01) with the largest effect size in the "medicine information and relation with healthcare providers" domain. DRPs decreased significantly after MTM implementation (11.97 ± 4.65 versus 7.63 ± 3.85 per patient, p<0.001). The mean adverse events per patient were also reduced (9.69 ± 4.12 versus 6.56 ± 3.77, p < 0.001).
CONCLUSION
Applying MTM services presents an opportunity to improve care for HD patients by improving MBQoL, decreasing DRPs and adverse events.
背景
血液透析（HD）患者通常接受多种药物治疗，这增加了药物相关问题（DRPs）和生活质量下降的可能性。药物治疗管理（MTM）服务可以发现和解决 DRPs，并可能特别改善 HD 患者的药物负担生活质量（MBQoL）。我们旨在评估 MTM 服务对 HD 患者 DRPs 和 MBQoL 的影响。
方法
在埃及亚历山大的一个 HD 病房进行了一项前瞻性的前后研究，对 104 名患者进行了研究。在 MTM 疗程三个月后，使用阿拉伯语、经过验证的患者报告药物治疗结果测量量表（PROMPT）问卷评估 MBQoL。使用 Cohen's d 检验和多元线性回归分别评估 MTM 的效果大小和影响 MBQoL 的因素。还监测了 DRPs、不良事件和依从性。
结果
在实施 MTM 后，MBQoL 显著改善（Cohen's d=0.88，p < 0.01），其中“药物信息和与医疗保健提供者的关系”领域的效果最大。在实施 MTM 后，DRPs 显著减少（每位患者 11.97 ± 4.65 与 7.63 ± 3.85，p<0.001）。每位患者的平均不良事件也减少（9.69 ± 4.12 与 6.56 ± 3.77，p < 0.001）。
结论
应用 MTM 服务为改善 HD 患者的护理提供了机会，通过提高 MBQoL、减少 DRPs 和不良事件来改善护理。
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