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临床药师参与慢性心力衰竭患者慢病管理的效果评价
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| 篇名： | 临床药师参与慢性心力衰竭患者慢病管理的效果评价 |
| TITLE： | Effect Evaluation of Clinical Pharmacists Participating in Chronic Disease Management for Chronic Heart Failure Patients |
| 摘要： | 目的：评价临床药师参与慢性心力衰竭（CHF）患者慢病管理的效果。方法：设计前瞻性研究方法，选择2016年1月－2017年12月我院收治的160例CHF患者，按随机数字表法分为干预组（80例）和对照组（80例）。入组患者均接受CHF常规检查和治疗，干预组患者在此基础上接受住院药学监护、出院用药教育和出院药学随访等临床药师慢病管理。比较两组患者入院时、出院时、出院6个月后的心功能指标[纽约心脏病协会（NYHA）心功能分级、左心室射血分数（LVEF）、N末端脑钠肽前体（NT-proBNP）、左室舒张末期内径（LVDd）]、综合自护能力（自理能力评分、用药依从性评分、对疾病相关知识的了解评分及其综合自护能力总分）、生活质量（情绪评分、症状评分、社会限制评分、生活质量总分），住院期间相关经济指标（总住院费用、住院时间、药品费用、药占比）以及出院6个月内的再住院与病死情况。结果：入院时，两组患者上述指标比较差异均无统计学意义（P＞0.05）；出院时，两组患者除LVEF、情绪评分和社会限制评分外，其余指标均较入院时显著改善（P＜0.05）；出院6个月后，两组患者上述指标均较入院时显著改善，且干预组患者的LVEF、LVDd、用药依从性评分、对疾病相关知识的了解评分、综合自护能力总分、情绪评分、症状评分、生活质量总分均显著优于对照组（P＜0.05）。两组患者总住院费用、住院时间、药品费用、药占比比较差异均无统计学意义（P＞0.05）。出院6个月内，干预组患者再住院率为14.29％，显著低于对照组的29.33％（P＜0.05）；两组患者病死率比较差异无统计学意义（P＞0.05）。结论：临床药师参与CHF患者慢病管理可显著改善患者心功能、综合自护能力和生活质量，降低再住院率。 |
| ABSTRACT： | OBJECTIVE：To evaluate the effect of clinical pharmacists participating in chronic disease management for chronic heart failure （CHF）patients. METHODS ：Totally 160 patients with CHF in our h ospital from Jan. 2016 to Dec. 2017 were divided into intervention group （80 cases）and control group （80 cases）according to random number table method. The patients received CHF routine examination and drug treatment at admission ；on this basis ，the patients in the intervention group received clinical pharmacist chronic disease management as inpatient pharmaceutical care ，medication education at discharge and pharamceutical follow-up at discharge. The cardiac function indexes （NYHA cardiac function classification ，LVEF，NT-proBNP，LVDd）， comprehensive self-care ability （scores of self-care ability ，drug compliance ，understanding of disease-related knowledge ，and total score of comprehensive self-care ability ），and life quality （emotional score ，symptom score ，social restriction score ，and total score of life quality ）at admission ，discharge and 6 months after discharge ；economic indicators （total hospitalization expenses ， hospitalization time ，drug expenses and drug proportion ）during hospitalization ；readmission and case fatality within 6 months after discharge were compared between the two groups. RESULTS ：At admission ，there was no significant difference in the above indicators between 2 groups（P＞0.05）；at discharge ，except for LVEF ，emotional score and social restriction score ，the other indicators in 2 groups were significantly improved ，compared with at admission （P＜0.05）；six months after discharge ，the above indicators of 2 groups were significantly improved compared with at admission ，and LVEF ，LVDd，drug compliance score ，score of understanding of disease-related knowledge ，total score of comprehensive self-care ability ，emotion score ，symptom score ，total score of life quality in the intervention group were significantly better than control group （P＜0.05）. There was no significant difference in the total hospitalization expenses ，hospitalization time ，drug expenses and drug proportion between 2 groups（P＞ 0.05）. Within 6 months after discharge ，the readmission rate of the intervention group was 14.29％，which was significantly lower than that（29.33％）of control group （P＜0.05）. There was no significant difference in case fatality rate between 2 groups（P＞ 0.05）. CONCLUSIONS ：The participation of clinical pharmacists in chronic disease management of CHF patients can significantly improve the cardiac function indexes ，comprehensive self-care ability and quality of life ，and reduce the readmission rate. |
| 期刊： | 2020年第31卷第06期 |
| 作者： | 饶兰兰，马添翼 |
| AUTHORS： | RAO Lanlan ，MA Tianyi |
| 关键字： | 慢性心力衰竭；慢病管理；临床药师；心功能；综合自护能力；生活质量 |
| KEYWORDS： | Chronic heart failure ；Chronic disease management ；Clinical pharmacist ；Cardiac function ；Comprehensive self- |
| 阅读数： | 346 次 |
| 本月下载数： | 18 次 |
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