临床药师主导慢病管理对心内科住院患者的实施状况及效果分析
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摘要
目的:探讨临床药师主导慢病管理在改善患者药物了解程度、提高健康素养中的作用。方法:通过分析临床药师对100例心内科老年高血压患者住院期间的慢病管理,调查临床药师在住院期间对患者进行的慢病管理,包括患者教育及接受患者咨询,评估患者入院时及出院时对药物的了解程度。结果:住院期间患者共咨询问题277例次,其中药物相关问题占比最高(45.1%),在药物相关问题中患者更关心的是药物的不良反应(26.4%)。药师主动对患者进行533例次的患者教育,其中就不良反应的教育占比最高(20.3%)。患者在出院时对药物的了解程度显著高于入院时(P<0.001)。结论:临床药师对患者住院期间的慢病管理可以显著改善患者对药物的了解程度,提高患者健康素养。
Objective: To discuss the role of chronic disease management led by clinical pharmacists in improving patients' understanding of drugs and health literacy through implementation of chronic disease management in 100 patients with hypertension in the department of cardiology.Methods: Based on analyzing the chronic disease management of 100 elderly patients with hypertension in cardiology department by clinical pharmacists during hospitalization, we investigated the patients' chronic disease management, including the patients' education and counseling, and evaluated the patients' understanding of drugs at admission and discharge. Results: During the hospitalization, there were 277 consultations, among which drug-related issues accounted for the highest proportion(45.1%). Among the drug-related questions, the patients were more concerned about adverse drug reactions(26.4%). Education was performed for 533 times on the patients by the pharmacist, with the highest proportion on adverse drug reactions(20.3%). The patients' understanding of drugs at discharge was significantly higher than that at admission(P<0. 01). Conclusion: Chronic diseases management by clinical pharmacists can significantly inprove the inpatients' understanding of drugs and health literacy.
Objective: To discuss the role of chronic disease management led by clinical pharmacists in improving patients' understanding of drugs and health literacy through implementation of chronic disease management in 100 patients with hypertension in the department of cardiology.Methods: Based on analyzing the chronic disease management of 100 elderly patients with hypertension in cardiology department by clinical pharmacists during hospitalization, we investigated the patients' chronic disease management, including the patients' education and counseling, and evaluated the patients' understanding of drugs at admission and discharge. Results: During the hospitalization, there were 277 consultations, among which drug-related issues accounted for the highest proportion(45.1%). Among the drug-related questions, the patients were more concerned about adverse drug reactions(26.4%). Education was performed for 533 times on the patients by the pharmacist, with the highest proportion on adverse drug reactions(20.3%). The patients' understanding of drugs at discharge was significantly higher than that at admission(P<0. 01). Conclusion: Chronic diseases management by clinical pharmacists can significantly inprove the inpatients' understanding of drugs and health literacy.
引文
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[12]曾庆奇,蒋莹,袁雁飞,等.糖尿病患者健康素养与健康管理的关系[J].中华预防医学杂志,2014, 48(8):715-719.
[13]黄海龙,黄海燕.社区2型糖尿病患者的健康素养水平及其与糖化血红蛋白(HbA_(1c))的关系[J].中国保健营养,2018, 28(13):120.
[14] World Health Organization. Noncommunicable Diseases[EB/OL].(2017-06-23)[2018-07-23]. http://www. who. int/en/newsroom/fact-sheets/detail/noncommunicable-diseases.
[15]秦江梅.中国慢性病及相关危险因素流行趋势、面临问题及对策[J].中国公共卫生,2014, 30(1):1-4.
[2]李旭琴,杨惠赟,毛凤飞,等.新版Beers标准评价社区多病种慢性病老年患者潜在性不适当用药的探索[J].世界临床药物,2015, 36(9):618-622.
[3] Kickbusch I. Health literacy:the solid facts[M].Geneva:WHO Regional Office for Europe, 2013.
[4]陈文衍,蔡卫民,马国.患者及其家属对临床药师与药学服务认知和需求情况调査研究[J].中国医院药学,2017, 37(24):2490-2495.
[5]李早玲,廖木生,廖羽偲.社区高血压患者健康教育需求调查[J].当代护士,2013(9):134-135.
[6]闫雪莲,刘晓红.优化老年人药物治疗策略[J].中华全科医师杂志,2018, 17(5):337-349.
[7]徐艳芳,张卫仙.健康教育对糖尿病患者知识认知程度及用药依从性的影响[J].中国药师,2014, 17(3):458-460.
[8]钱懿轶,吴迪,张峻.临床药师对156例高血压患者出院用药教育效果评价与体会[C]//中国药理学会治疗药物监测研究专业委员会.第四届全国治疗药物监测学术年会资料汇编.长沙:中国药理学会治疗药物监测研究专业委员会,2014:1106-1109.
[9]中国高血压防治指南修订委员会.中国高血压防治指南(2010年版)[J].中国医学前沿杂志:电子版,2011,3(5):42-52.
[10]张庆华,黄菲菲,朱爱群,等.国内外慢性病健康素养的研究进展[J].中国全科医学,2014, 17(7):814-817.
[11] Seurer A C, Vort H B. Low health literacy:a barrier to effective patient care[J]. S D Med, 2013, 66(2):51, 53-57.
[12]曾庆奇,蒋莹,袁雁飞,等.糖尿病患者健康素养与健康管理的关系[J].中华预防医学杂志,2014, 48(8):715-719.
[13]黄海龙,黄海燕.社区2型糖尿病患者的健康素养水平及其与糖化血红蛋白(HbA_(1c))的关系[J].中国保健营养,2018, 28(13):120.
[14] World Health Organization. Noncommunicable Diseases[EB/OL].(2017-06-23)[2018-07-23]. http://www. who. int/en/newsroom/fact-sheets/detail/noncommunicable-diseases.
[15]秦江梅.中国慢性病及相关危险因素流行趋势、面临问题及对策[J].中国公共卫生,2014, 30(1):1-4.