今日药学

2021, v.31(09) 697-701

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基于PCNE分类系统对肾病综合征患者的药学干预实践
Pharmaceutical Intervention Practice for Nephrotic Syndrome Patients based on PCNE Classification System

陈芳辉;黄子倩;刘小云;彭妍;唐远鹏;钟秋明;
CHEN Fanghui;HUANG Ziqian;LIU Xiaoyun;PENG Yan;TANG Yuanpeng;ZHONG Qiuming;The First Affiliated Hospital of Gannan Medical Uniwersity;

摘要(Abstract):

目的探讨欧洲药学监护联盟(PCNE)分类系统在肾病综合征患者药物相关问题(DRPs)中的应用,观察药学干预对肾病综合征患者临床疗效的影响。方法将我院肾内科2020年8~10月诊断为肾病综合征的住院患者随机分为临床药师主导的干预组和仅接受常规治疗的对照组。干预组中药师利用PCNE分类系统分析并评估DRPs的数量、问题类型、发生原因、干预类型、干预方案的接受及DRPs状态。比较入院时和出院2个月时两组患者的用药依从性及出院2个月时两组患者的疗效。结果共纳入病例68例,对照组34例,干预组34例。干预组共发现70个DRPs,其中治疗效果问题34个(48.57%),治疗安全性问题14个(20.00%),其他问题22个(31.43%);分析DRPs的原因74个,其中药物选择32个(43.24%),剂量选择13个(17.57%),患者相关25个(33.78%),DRPs干预接受率达94.59%,DRPs得到完全解决的比率为88.57%。出院2个月时干预组的用药依从性较入院时明显提高(P<0.05),且明显高于对照组(P<0.05)。干预组完全缓解及部分缓解的人数更多,复发人数更少,患者疗效更好(P<0.05)。结论药师利用PCNE分类系统对肾病综合征患者进行药学干预,可减少患者的DRPs并改善其用药依从性,从而提升治疗效果。
OBJECTIVE To explore the application of the Pharmaceutical Care Network Europe(PCNE) classification system in the treatment of drug-related problems(DRPs) in patients with nephrotic syndrome, and to observe the effect of pharmaceutical intervention on the clinical efficacy of patients with nephrotic syndrome. METHODS The patients with nephrotic syndrome diagnosed in nephrology department of our hospital from August to October of 2020 were randomly divided into the clinical pharmacist-led intervention group and the control group receiving only routine treatment services. According to PCNE classification, the number of DRPs found in the intervention group, the types of problems, causes, the types of interventions, acceptance for interventions and DRPs status were analyzed and evaluated. Drug compliance were compared between two groups during hospitalization and 2 months after discharge. The efficacy of the two groups was compared at two months after discharge. RESULTS A total of 68 cases included were divided into two groups equally. A total of 70 DRPs were found in the intervention group. There were 34(48.57%) problems about treatment effect, 14(20.00%) problems about treatment safety, and 22(31.43%) problems about other problems. There were 74 reasons for DRPs, among which 32 were related to drug selection(43.24%),13 were related to dose selection(17.57%) and 25 were related to patients(33.78%). The acceptance rate of DRPs intervention was 94.59%. The percentage of DRPs fully resolved was 88.57%. After two months' intervention of pharmacists, the compliance of the intervention group was significantly higher than that at admission(P<0.05),and that of the control group(P<0.05). Compared with the control group, more patients in the intervention group were complete or partial remission, the number of relapse were less, and the patients in the intervention group had better efficacy(P<0.05). CONCLUSION Pharmacists using PCNE classification system for pharmaceutical intervention of patients with nephrotic syndrome can reduce patients' DRPS and improve their medication compliance, so as to enhance the therapeutic effect.

关键词(KeyWords): 欧洲药学监护联盟分类系统;药学干预;肾病综合征;用药依从性;药物治疗效果
PCNE classification system;pharmaceutical intervention;nephrotic syndrome;drug compliance;drug therapeutic effect

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基金项目(Foundation): 江西省卫生计生委科技计划(20195394);; 赣州市指导性科技计划(GZ2015ZSF020);; 赣南医学院第一附属医院2020年度院级科技计划项目(YJYB202043)

作者(Author): 陈芳辉;黄子倩;刘小云;彭妍;唐远鹏;钟秋明;
CHEN Fanghui;HUANG Ziqian;LIU Xiaoyun;PENG Yan;TANG Yuanpeng;ZHONG Qiuming;The First Affiliated Hospital of Gannan Medical Uniwersity;

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