急性冠心症藥事服務標準化模式應用於病人預後之成效研討

Effects of a Standardized Pharmaceutical Care Program on Prognosis in Patients with Acute Coronary Syndrome

蕭雅方(Ya-Fang Shiau) ； 吳俊賢(Giuen Hsian Wu) ； 李宜勳(I-Hsun Li) ； 謝政智(Cheng-Chih Hsieh)

《臺灣臨床藥學雜誌》 25卷1期 (2017/01) Pp. 25-34

https://doi.org/10.6168/FJCP.2017.2501.04

摘要

目的：評估急性冠心症藥事服務標準化模式之執行對因心臟疾病再入院率、治療指引建議藥物開立率和病人藥物認知之成效。方法：民國104年3月至8月實施急性冠心症藥事服務標準化作業流程，提供醫師藥物建議和病人出院前用藥指導（介入組），並以接受常規照護之回溯性病人資料（控制組），比較兩組一個月和三個月內因心臟疾病再入院率。另分析出院急性冠心症藥物開立率、病人藥物認知、和用藥指導滿意度。結果：本研究收納36位病人於介入組，其中2位病人失去追蹤。介入組和控制組最終病人數皆為34人，且兩組病人基本特性一致(P ＞ 0.05)。兩組病人出院後一個月和三個月內因心臟疾病再入院率皆沒有差異(P ＞ 0.05)。相較控制組，介入組出院開立statin比率提升20.6%(P ＜ 0.05)。經用藥指導後，五項藥物認知正確率皆為100.0%。用藥指導滿意度結果顯示76.5%和23.5%介入組病人對藥師提供之衛教分別感到非常滿意和滿意。結論：雖然兩組間因心臟疾病再入院率沒有差異，然而急性冠心症藥事服務標準化模式能提供病人適當的藥物治療，增進正確藥物認知，及提升藥事照護滿意度。

關鍵字

急性冠心症 ； 再入院 ； 藥事照護

並列摘要

Objective: To evaluate the impacts of a standardized pharmaceutical care program on cardiac-related readmission, prescription rate of guideline-based medication, and medication cognition in patients with acute coronary syndrome (ACS). Methods: We performed a standardized pharmaceutical care program for ACS from March 2015 through August 2015. The pharmacist made recommendations to doctors and educated patient before discharge (the intervention group).A retrospective data was collected from patients who received regular practice care (the controlled group). The primary outcomes are cardiac-related readmission within one month and three months. The secondary outcomes are prescription rate of ACS medication at discharge, medication cognition, and satisfaction of patient education. Results: A total of 36 patients were enrolled in the pharmaceutical care program, but 2 patients lost to follow-up. The final patient numbers in both groups were 34 patients. Baseline characteristics were uniform between groups. There was no significant difference in cardiac-related readmission within one month or three months (P ＞ 0.05). Compared with the control group, the prescription rate of statin increased by 20.6% (P ＜ 0.05) in the intervention group. The accuracy rate of medication cognition was raised to 100.0% after patient education. In the intervention group, 76.5% of patients were very satisfied and 23.5% of patients were satisfied with patient education by the pharmacist, respectively. Conclusions: The decrease of cardiac-related readmission was not found in the present study. However, the ACS pharmaceutical care program can provide the appropriate guideline-based therapy, improve medication cognition, and elevate the satisfaction of patient education.

並列關鍵字

Acute Coronary Syndrome ； Readmission ； Pharmaceutical Care