Page 126 - 《中国药房》2024年4期

基于患者疾病自我管理能力的下肢动脉疾病药学服务模式的构建 Δ

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江书正 ，陈 熙 ，陈飞宇 ，张韶辉 （1.武汉市第一医院药学部，武汉 430022；2.武汉市第一医院血管外科，
武汉 430022）
中图分类号 R969.3 文献标志码 A 文章编号 1001-0408（2024）04-0500-06
DOI 10.6039/j.issn.1001-0408.2024.04.22

摘 要 目的 构建下肢动脉疾病（LEAD）患者院内药学监护＋院外药学门诊一体化服务模式，提高患者的疾病自我管理能力及
疾病治疗的有效性和安全性。方法 构建LEAD患者院内药学监护及院外药学门诊服务模式（包含药学评估、自我管理能力宣教、
药学随访），对患者进行长期管理。选取2021年9月－2022年12月在我院血管外科住院或门诊就诊并经药师管理的65例LEAD
患者为研究对象，由药师进行院内药学监护＋院外门诊持续管理，比较经药师管理3个月前后疾病治疗有效性指标、安全性指标
和患者疾病自我管理能力指标。结果 65例患者经药师管理3个月后，55例患者Fontaine分期降低，管理前后Fontaine分期差异有
统计学意义（P＜0.001）；完全遵循指南用药的患者占比由63.1%提升至96.9%，小出血发生率减少7.7%，患者Morisky用药依从性
评分和疾病自我管理能力评分显著提高（P＜0.001），就医满意度为“好”的患者占比增加了18.4%。结论 LEAD患者院内外一体
化药学服务模式可有效提高患者疾病自我管理能力，提高患者疾病治疗的有效性及安全性。
关键词 下肢动脉疾病；疾病自我管理能力；药学服务；药学门诊

Establishment of pharmaceutical care model for lower extremity artery disease based on patients’ disease
self-management ability
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JIANG Shuzheng ，CHEN Xi ，CHEN Feiyu ，ZHANG Shaohui（1. Dept. of Pharmacy， Wuhan No.1 Hospital，
Wuhan 430022， China；2. Dept. of Vascular Surgery， Wuhan No.1 Hospital， Wuhan 430022， China）
ABSTRACT OBJECTIVE To construct the integrated pharmaceutical care model of in-hospital pharmaceutical care+out-hospital
pharmacy outpatient service for patients with lower extremity artery disease （LEAD）， so as to improve patients’ disease self-
management ability， and the efficacy and safety of therapy. METHODS The in-hospital pharmaceutical care and out-hospital
pharmacy outpatient service model was constructed for LEAD patients， including pharmaceutical evaluation， self-management
ability education， and pharmacy follow-up， to perform long-term management of patients. Totally 65 LEAD patients admitted to the
vascular surgery department of our hospital， receiving pharmacist management， from September， 2021 to December， 2022 were
selected as the study objects， and pharmacists conducted in-hospital pharmaceutical care+continuous out-patient management. The
efficacy indicators， safety indicators， and patients’s disease self-management ability indicators were compared before and after 3
months of pharmacist management. RESULTS After 3 months of pharmacists’ participation in the management of 65 patients，
Fontaine stage decreased in 55 patients， there was the significant difference in Fontaine stage before and after management （P＜
0.001）. The proportion of patients who completely followed the guidelines for medication increased from 63.1% to 96.9%； the
incidence of small bleeding was reduced by 7.7% after pharmacists’ management. The scores of Morisky medication compliance
and patients’ disease self-management ability were higher than 3 months ago （P＜0.001）. Patient proportion with “good” medical
satisfaction increased by 18.4%. CONCLUSIONS The in-hospital pharmaceutical care and out-hospital pharmacy outpatient service
model of LEAD patients can effectively improve patients’ disease self-management ability， and improve the efficacy and safety of
therapy.
KEYWORDS lower extremity artery disease； disease self-management ability； pharmaceutical care； pharmaceutical clinic

下 肢 动 脉 疾 病（lower extremity artery disease， LEAD）是外周动脉疾病（peripheral artery disease，PAD）
最主要的疾病表现形式，是指因下肢动脉硬化狭窄闭塞
Δ 基金项目 湖北省卫生健康委科研项目（No.WJ2023M125）；湖
北省卫生健康委联合基金项目（No.WJ2019H234，No.WJ2019H229） 导致的肢体缺血疼痛甚至坏死。我国 35 岁及以上的成
＊第一作者 主管药师，硕士。研究方向：临床药学。E-mail： 年人中有6.6%（估计为4 530万）患有PAD，75岁后PAD
691054072@qq.com
[1]
的患病率显著增加 。PAD 是仅次于冠心病、脑卒中的
# 通信作者 副主任药师，博士。研究方向：临床药学、合理用药管
理。E-mail：53685340@qq.com 第三大动脉粥样硬化性心血管疾病，可导致脑卒中、冠

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