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基于数据挖掘的临床药学康复模式的系统性分析

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目的 系统性分析基于数据挖掘的临床药学康复模式,以探究其在提高药物治疗效果、降低药物不良反应以及优化患者康复体验等方面的潜力和作用。方法 检索中国知网、万方、维普、PubMed已发表的临床药学康复相关的文献,检索时间为自建库至 2024 年 5 月 30 日。结果 共纳入 11 篇文献。1 篇涉及 69 项随机对照试验的文献分析结果显示,高血压控制率(OR=2。71,95%CI:1。03~7。01)、2 型糖尿病控制率(OR=3。12,95%CI:1。12~5。84)、高胆固醇控制率(OR=1。90,95%CI:1。05~3。35)均得到提高,表明药师的用药审核有助于提升高血压、2 型糖尿病和高胆固醇的控制效果。1 篇含 6 项随机对照试验的文献对 2 573 例慢性肾脏病患者的疗效进行观察,结果显示血压控制水平(OR=1。51,95%CI:1。13~2。03)得到提升,表明血压监测、生活方式和用药方案评估提高了慢性肾脏病患者的血压控制水平。1 篇涵盖 8 项研究的Meta分析文献中,包括 5 项随机对照试验和 3 项观察性研究,结果显示接受用药教育和行为干预的患者中,尿酸<360 μmol·L-1 的比例更高,尿酸控制率提高。1 篇纳入 14 个RCT共 4 509 例患者的Meta分析显示,药师的用药教育、用药咨询等干预降低了高血压、糖尿病患者的 30 d再入院率(RR=0。75,95%CI:0。53~0。96)。1 篇纳入 18 个随机对照试验中共涉及 7 244 名患者的文献显示,药师主导的出院相关咨询降低了患者的再入院率,表明药师在出院环节中的关键作用,再入院率降低(RR=0。864,95%CI:0。763~0。997,P=0。020)。1 篇含 8 个研究的文献评估了不同团队药师开展的药学相关服务对患者再入院率的影响,结果显示,接受药学相关服务的患者再入院率降低(OR=0。74,95%CI:0。62~0。89),患者再入院的风险减少了 32%。1 篇综合了 123项研究的Meta文献分析了药师在患者护理服务中的介入对降低患者再次入院率的效果,结果显示,药师的介入使患者再次入院率有所下降,其中最大下降幅度可达 44。5%。1 篇纳入了 23项RCT的Meta文献,旨在评估药师干预的相关措施对老年人药品不良事件的影响,结果显示,药师主导的药物审查和用药教育可以减少养老院老年人的药品不良事件。1 篇纳入了 14 项RCT及干预性研究的文献,旨在探讨药师参与的多学科团队照护对药品不良事件的影响,结果显示,药师参与的多学科团队照护与药品不良事件发生率的降低相关(RR=0。47,95%CI:0。28~0。77,P<0。01)。1 篇综合了 6 项RCT的Meta分析涵盖了 29 291 名儿童住院患者,揭示了药师在减少儿科患者用药错误中的作用,结果表明,药师的介入能有效地降低儿童住院患者发生用药错误的风险(OR=0。27,95%CI:0。15~0。49)。1 篇分析临床药学服务在患者药物治疗中的效果的文献,结果显示,在使用抗菌药物治疗的患者中,引入临床药学服务模式能够降低抗菌药物的使用率,减少医疗费用,提升用药服务满意度。结论 临床中深入探究临床药学康复模式,对临床治疗具有重要的作用,能够提高患者疾病康复的有效率、降低不良反应发生率。
Systematic analysis of clinical pharmaceutical rehabilitation model based on data mining
Objective To systematically analyze the clinical pharmaceutical rehabilitation model based on data mining,so as to explore its role in improving drug treatment efficacy,reducing drug side effects,and optimizing rehabilitation experience.Methods We retrieved published literatures related to clinical pharmaceutical rehabilitation from CNKI,Wanfang,VIP,and PubMed,with a search time from inception to June 30,2022.Results Totally 11 articles were enrolled in this study.A study involving 69 randomized controlled trials(RCTs)demonstrated that the involvement of pharmacists in medication reviews significantly improved the control of hypertension,type 2 diabetes,and high cholesterol.The odds ratio(OR)for improved control was 2.71(95%confidence interval[CI]:1.03-7.01)for hypertension,3.12(95%CI:1.12-5.84)for type 2 diabetes,and 1.90(95%CI:1.05-3.35)for high cholesterol.A study involving 6 RCTs and 2 573 patients with chronic kidney disease(CKD)showed that pharmacist-led blood pressure monitoring,lifestyle,and medication regimen assessments significantly improved blood pressure control in CKD patients,with an OR of 1.51(95%CI:1.13-2.03).A Meta-analysis,including 5 RCTs and 3 observational studies,explored the impact of medication education and behavioral interventions on the treatment outcomes of gout.The results revealed that patients receiving medication education and behavioral interventions had a significantly higher rate of uric acid control and a higher proportion of patient with uric acid less than 360 μmol/L.A Meta-analysis of 14 RCTs involving 4 509 patients showed that pharmacist interventions such as medication education and counseling significantly reduced the 30-day readmission rates for hypertension and diabetes patients,with a relative risk(RR)of 0.75(95%CI:0.53-0.96).Eighteen RCTs involving 7 244 patients investigated the impact of pharmacist-led discharge counseling on the readmission rate.The findings showed that discharge counseling significantly reduced readmission rate,with a RR of 0.864(95%CI:0.763-0.997,P=0.020).Eight studies assessed the impact of pharmacist services on readmission rate,and the result showed that patients receiving pharmacy-related services had significantly reduced readmission rates,with a 32%reduction in the risk of readmission(OR=0.74,95%CI:0.62-0.89).A Meta-analysis including 123 studies investigated the effect of pharmacist interventions in patient care on the readmission rate,and the result indicated that pharmacist interventions led to a decrease in readmission rates,with the maximum decrease of 44.5%.A Meta-analysis of 23 RCTs evaluated the impact of pharmacist interventions on medication-related adverse events in elderly residents of nursing homes.The study found that pharmacist-led medication reviews and education significantly reduced adverse events.Another Meta-analysis of 14 RCTs and intervention studies explored the effect of pharmacist involvement in multidisciplinary care on medication-related adverse events.The analysis showed that pharmacist participation in multidisciplinary care was significantly associated with a reduction in the incidence of adverse events(RR=0.47,95%CI:0.28-0.77,P<0.01).A Meta-analysis of 6 RCTs involving 29 291 pediatric inpatients revealed that pharmacist interventions effectively reduced the risk of medication errors in hospitalized children(OR=0.27,95%CI:0.15-0.49).A literature analysis on the effectiveness of clinical pharmaceutical services in patient drug treatment showed that introducing a clinical pharmaceutical service model can reduce the use of antibiotics,lower medical costs,and improve medication satisfaction among patients treated with antibiotics.Conclusion In-depth exploration of clinical pharmaceutical rehabilitation model plays an important role in clinical treatment,which can improve the effectiveness of rehabilitation and reduce the incidence of adverse reactions.

Clinical pharmacyRehabilitationData mining

宋畅、朱春烁、关帅、焦映棋、王凤锦、张吉艳、高惟英、张佳莉、徐乐乐

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066000 河北秦皇岛,联勤保障部队北戴河康复疗养中心药剂科

河北省秦皇岛市中医医院药剂科

066000 河北秦皇岛,联勤保障部队北戴河康复疗养中心疗养八科

066000 河北秦皇岛,联勤保障部队北戴河康复疗养中心精神心理科

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临床药学 康复 数据挖掘

河北省卫生健康委医学科学研究课题计划项目

20250931

2024

海军医学杂志
海军医学研究所

海军医学杂志

CSTPCD
影响因子:0.518
ISSN:1009-0754
年,卷(期):2024.45(9)