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药剂师主导的药物治疗对心力衰竭患者健康相关和药物治疗相关生活质量的影响:一项随机对照试验。

Impact of pharmacist-led pharmaceutical care on health-related and pharmaceutical therapy-related quality of life in patients with heart failure: A randomized controlled trial.

机构信息

Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Phyathai Road, Pathumwan, Bangkok, 10330, Thailand.

Pharmacy Unit, Ayutthaya Hospital, Thailand.

出版信息

Res Social Adm Pharm. 2024 Nov;20(11):1058-1063. doi: 10.1016/j.sapharm.2024.08.003. Epub 2024 Aug 13.

Abstract

BACKGROUND

Data on the impact of pharmacist-led pharmaceutical care (PC) on pharmaceutical therapy-related and health-related quality of life (HRQoL) and their sensitivities to PC provision in patients with heart failure (HF) are scarce.

OBJECTIVES

This study aimed to assess the impact of pharmacist-led PC on HRQoL employing the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and 5-level EuroQol 5 dimension (EQ-5D-5L) and on pharmaceutical therapy-related quality of life using the Patient-Reported Outcomes Measure of Pharmaceutical Therapy (PROMPT) in HF patients and compare sensitivities to the PC provision of these three tools.

METHODS

A single-blinded randomized controlled trial was conducted at a tertiary public hospital in Thailand between November 2022 and May 2023. Overall, 250 patients were randomly divided into the usual care (UC) (N = 124) and PC (N = 126) groups. Mixed effects models were used to investigate the differences in the mean change scores of PROMPT, EQ-5D-5L, and MLHFQ between the UC and PC groups. The sensitivities to PC provision of the three measures were evaluated using standardized effect sizes (SESs).

RESULTS

Significant differences were found in five of eight domains and the total score of the PROMPT between the PC and UC groups (all p < 0.05). However, no significant differences were found in the EQ-5D-5L and MLHFQ between the two groups (both p > 0.05). The SESs of the five domains and total score of PROMPT ranged from 0.29 to 1.65, considered small-to-large effect sizes, whereas the SESs of EQ-5D-5L and MLHFQ were -0.4 to 0, considered small effect sizes.

CONCLUSIONS

Pharmacist-led PC can positively affect pharmaceutical therapy-related quality of life using PROMPT in HF patients. Additionally, PROMPT is more sensitive to PC provision than EQ-5D-5L and MLHFQ.

摘要

背景

关于药剂师主导的药物治疗(PC)对心力衰竭(HF)患者药物治疗相关和健康相关生活质量(HRQoL)的影响及其对 PC 提供的敏感性的数据很少。

目的

本研究旨在使用明尼苏达州心力衰竭生活质量问卷(MLHFQ)和 5 级欧洲五维健康量表(EQ-5D-5L)评估药剂师主导的 PC 对 HRQoL 的影响,并使用患者报告的药物治疗结果测量工具(PROMPT)评估对 HF 患者药物治疗相关生活质量的影响,并比较这三种工具对 PC 提供的敏感性。

方法

2022 年 11 月至 2023 年 5 月,在泰国一家三级公立医院进行了一项单盲随机对照试验。共有 250 名患者被随机分为常规护理(UC)(N=124)和 PC(N=126)组。混合效应模型用于研究 UC 和 PC 组之间 PROMPT、EQ-5D-5L 和 MLHFQ 的平均变化评分差异。使用标准化效应量(SES)评估三种措施对 PC 提供的敏感性。

结果

在 PROMPT 的八个领域中的五个领域和总分中,PC 组与 UC 组之间存在显著差异(均 p<0.05)。然而,两组之间在 EQ-5D-5L 和 MLHFQ 方面没有发现显著差异(均 p>0.05)。PROMPT 的五个领域和总分的 SES 范围从 0.29 到 1.65,被认为是小到大的效应量,而 EQ-5D-5L 和 MLHFQ 的 SES 为-0.4 到 0,被认为是小效应量。

结论

药剂师主导的 PC 可以通过使用 PROMPT 对 HF 患者的药物治疗相关生活质量产生积极影响。此外,与 EQ-5D-5L 和 MLHFQ 相比,PROMPT 对 PC 提供更为敏感。

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