临床药师干预膝骨关节炎病人自我管理行为的效果评价
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摘要
目的评价临床药师干预膝骨关节炎(knee osteoarthritis,KOA)病人自我管理行为的效果。方法选取2015年1月至2016年1月中国人民解放军联勤保障部队第九〇一医院收治的62例KOA病人,采用随机数字表法分为干预组和对照组,每组各31例。对照组采取常规治疗,干预组在常规治疗的基础上进行用药档案建立、功能锻炼指导及出院用药教育等有针对性的临床药师干预,干预时间为4周。采用自制满意度调查表、自我管理行为量表、健康调查简表(SF-36)评价干预前后病人满意度、自我管理水平及生活质量各维度评分变化。结果临床药师参与开展KOA健康管理,干预组总满意率93.55%、自我管理水平评分及SF-36评分均显著高于对照组,差异有统计学意义(P<0.05)。结论临床药师参与KOA慢性病病人的药学干预能够明显增强KOA病人的治疗满意度,增强疾病的自我管控水平,提高用药依从性,从而改善病人的生存质量。
Objective To evaluate the pharmaceutical intervention effect of self-management behavior in patients with knee osteoarthritis(KOA).Methods Sixty-two patients with KOA treated in the 901 st Hospital of the Joint Logistics Support Force of PLA from January 2015 to January 2016 were randomly assigned into intervention group and control group,with 31 cases in each.The control group received routine treatment,while the intervention group,in addition to the routine treatment,carried on the intervention of clinical pharmacists for 4 weeks,including the establishment of drug dossier,the guidance of functional exercise and education on drug use after discharge from hospital.Self-made questionnaire about the satisfaction of treatment,self-management behavior scale,short form-36 health status questionnaire(SF-36) were used to compare and evaluate satisfaction of patients and their self-management capacity and changes in dimensional scores of quality of life before and after intervention.Results After the intervention,the ratio of total satisfaction(93.55%) and total scores of self-management behavior and SF-36 in intervention group were significantly higher than those in control group; the differences were statistically significant(P<0.05).Conclusion Pharmacological intervention is helpful to significantly improve satisfaction of treatment,enhance self-management behaviors and improve the medication compliance in patients with KOA,thus promoting quality of life.
Objective To evaluate the pharmaceutical intervention effect of self-management behavior in patients with knee osteoarthritis(KOA).Methods Sixty-two patients with KOA treated in the 901 st Hospital of the Joint Logistics Support Force of PLA from January 2015 to January 2016 were randomly assigned into intervention group and control group,with 31 cases in each.The control group received routine treatment,while the intervention group,in addition to the routine treatment,carried on the intervention of clinical pharmacists for 4 weeks,including the establishment of drug dossier,the guidance of functional exercise and education on drug use after discharge from hospital.Self-made questionnaire about the satisfaction of treatment,self-management behavior scale,short form-36 health status questionnaire(SF-36) were used to compare and evaluate satisfaction of patients and their self-management capacity and changes in dimensional scores of quality of life before and after intervention.Results After the intervention,the ratio of total satisfaction(93.55%) and total scores of self-management behavior and SF-36 in intervention group were significantly higher than those in control group; the differences were statistically significant(P<0.05).Conclusion Pharmacological intervention is helpful to significantly improve satisfaction of treatment,enhance self-management behaviors and improve the medication compliance in patients with KOA,thus promoting quality of life.
引文
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[12] HOCHBERG MC,ALTMAN RD,APRIL KT,et al.American College of Rheumatology 2012 recommendation for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand,and knee[J].Arthritis Care Res(Hoboken),2012,64(4):465-474.
[13] KIELLY J,DAVIS EM,MARRA C,et al.Practice guidelines for pharmacists:the management of osteoarthritis[J].Can Pharm J (Ott),2017,150(3):156-168.
[2] 曹月龙,高宁阳,庞坚,等.国际骨关节炎研究学会髋与膝关节炎治疗指南-第二部分:基于循证和专家共识之治疗指南[J].国际骨科学杂志,2009,30(4):208-217.
[3] 中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[4] LORIG KR,STEWART AL,RITTER PL,et al.Outcome measures for health education and health care interventions[M].Thousand Oaks,CA:Sage Publications,1996:36.
[5] WARE JE,SHERBOURNE CD.The MOS 36-item short-form health survey (SF-36).I.Conceptual framework and item selection[J].Med Care,1992,30(6):473-483.
[6] 卜书红.临床药师慢性病管理服务模式的探索[J].中华医学信息导报,2016,31(10):19.
[7] COLEMAN S,BRIFFA NK,CARROLL G,et al.A randomised controlled trial of a self-management education program for osteoarthritis of the knee delivered by health care professionals[J].Arthritis Res Ther,2012,14(1):R21.
[8] 梁长秀.慢病管理中健康管理的应用[J].中国社区医师:医学专业,2011,13(4):211-212.
[9] BODENHEIMER T,WAGNER EH,GRUMBACH K.Improving primary care for patients with chronic illness:the chronic care model,Part 2[J].JAMA,2002,288(15):1909-1914.
[10] RETA A,DASHTAEI A,LIM S,et al.Opportunities to improving clinical outcomes and challenges to implementing clinical pharmacists into health care teams [J].Prim Care,2012,39(4):615-626.
[11] 王庆,徐桂华,钱先,等.老年类风湿关节炎患者自我管理行为与自我效能的相关性[J].中国老年学杂志,2015 35(16):4684-4685.
[12] HOCHBERG MC,ALTMAN RD,APRIL KT,et al.American College of Rheumatology 2012 recommendation for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand,and knee[J].Arthritis Care Res(Hoboken),2012,64(4):465-474.
[13] KIELLY J,DAVIS EM,MARRA C,et al.Practice guidelines for pharmacists:the management of osteoarthritis[J].Can Pharm J (Ott),2017,150(3):156-168.