Page 122 - 《中国药房》2024年23期

基于健康行为改变整合理论的抗凝药学服务模式构建与应用
Δ

2
1＊
2 #
梁侠兵 ，凡保华 ，文志萍 ，王晓义 （1.石河子大学药学院，新疆 石河子 832003；2.石河子大学第一附属医
1
院药学部，新疆 石河子 832000）
中图分类号 R973+.2 文献标志码 A 文章编号 1001-0408（2024）23-2948-06
DOI 10.6039/j.issn.1001-0408.2024.23.18

摘 要 目的 建立药师主导的基于健康行为改变整合理论（ITHBC）的抗凝药学服务模式，并分析其应用效果。方法 参考相关
文献，并征求药学部、呼吸科、血管外科等科室共8名多学科专家意见，最终形成药师主导的基于ITHBC的抗凝药学服务模式。选
择2023年12月－2024年6月石河子大学第一附属医院的VTE住院患者为研究对象，采用随机数字表法将其分为干预组（58例）
和对照组（60例）。干预组采取药师主导的基于ITHBC的抗凝药学服务模式，对照组采取常规抗凝药学服务模式。比较两组患者
启动抗凝治疗3个月时的抗凝达标率、药物不良反应发生率、用药依从性评分、抗凝药物处方依从率，并进行经济学评价。结果
在启动抗凝治疗3个月时，干预组患者抗凝达标率、用药依从性评分、抗凝药物处方依从率均显著高于对照组（P＜0.05）。两组患
者的药物不良反应总发生率差异无统计学意义（P＞0.05）。每增加1%的抗凝达标率，医院需多投入的药师服务费用为4.35元。
与2023年我国人均国内生产总值（GDP，89 358元）相比，增加50%抗凝达标率的增量成本-效果比值远低于1倍人均GDP。结论
药师主导的基于ITHBC的抗凝药学服务模式可有效改善VTE患者抗凝治疗结局，提升患者用药依从性，提高患者对抗凝药物不
良反应的认识和识别能力，具有一定的经济和社会效益。
关键词 健康行为改变整合理论；静脉血栓栓塞症；抗凝治疗；药学服务；用药依从性

Construction and application of anticoagulant pharmacy service model based on the integrated theory of
health behavior change
2
2
1
1
LIANG Xiabing ，FAN Baohua ，WEN Zhiping ，WANG Xiaoyi（1. School of Pharmacy， Shihezi University，
Xinjiang Shihezi 832003， China；2. Dept. of Pharmacy， the First Affiliated Hospital of Shihezi University，
Xinjiang Shihezi 832000， China）
ABSTRACT OBJECTIVE To establish anticoagulation pharmaceutical service model based on the integrated theory of health
behavior change （ITHBC）， and analyze its effects. METHODS Referring to relevant literature and soliciting opinions from 8
experts from departments such as pharmacy， respiratory medicine， and vascular surgery， a anticoagulation pharmaceutical service
model based on ITHBC was ultimately formed. VTE inpatients were selected from The First Affiliated Hospital of Shihezi
University from December 2023 to June 2024 as the research subjects. They were randomly assigned into intervention group （58
cases） and control group （60 cases） using a random number table method. The intervention group implemented pharmacist-led
anticoagulant pharmaceutical service model based on ITHBC， while the control group adopted a conventional anticoagulant
pharmaceutical service model. The anticoagulation-related outcomes of two groups were compared after 3 months： anticoagulation
compliance rate， the incidence of adverse drug reactions， the score of medication adherence and compliance rate of anticoagulant
prescription； economic evaluation was conducted. RESULTS After implementing ITHBC-based anticoagulant pharmaceutical
services for 3 months， the intervention group had higher anticoagulation compliance rate， score of medication adherence， and
compliance rate of anticoagulant prescription than the control group （P＜0.05）. There was no statistically significant difference in
the total incidence of adverse drug reactions between the two groups （P＞0.05）. For every 1% point increase in anticoagulant
compliance rate， the hospital needed to invest 4.35 yuan additionally in anticoagulant pharmaceutical service fees. Compared with
China’s per capita gross domestic product （GDP， 89 358 yuan） in 2023， the incremental cost-effectiveness ratio value that
increased the anticoagulation compliance rate by 50% is far less than one time of per capita GDP. CONCLUSIONS The pharmacist-
led anticoagulant pharmaceutical service model based on ITHBC can effectively improve the outcomes of anticoagulant therapy for
VTE patients， enhance medication compliance， improve patients’ awareness and recognition of adverse drug reactions to
anticoagulants， and has certain economic and social benefits.
KEYWORDS integrated theory of health behavior change； venous thromboembolism； anticoagulant therapy； pharmaceutical
care； medication compliance

Δ 基金项目 石河子大学自然科学基金项目（No.ZZZC2023055）
＊第一作者 硕士研究生。研究方向：临床药学及药物评价。 静脉血栓栓塞症（venous thromboembolism，VTE）
E-mail：780962468@qq.com
包括深静脉血栓形成（deep venous thrombosis，DVT）和
# 通信作者 副主任药师，硕士生导师。研究方向：临床药学。
[1]
E-mail：1369881248@qq.com 肺栓塞（pulmonary embolism，PE） 。抗凝治疗是 VTE

· 2948 · China Pharmacy 2024 Vol. 35 No. 23 中国药房 2024年第35卷第23期