家庭药师服务模式管理老年高血压患者的药物经济学评价
Pharmacoeconomic Evaluation of Family Pharmacist Service Model in the Management of Elderly Patients with Hypertension
高艳玲 1周敏华 1区惠燕2
作者信息
- 1. 广东省中西医结合医院药学部,广东佛山 528200
- 2. 佛山市南海区桂城街道社区卫生服务中心,广东佛山 528200
- 折叠
摘要
目的 评价对老年高血压患者实施家庭药师服务的经济学价值.方法 选取佛山市南海区桂城社区的 200 例老年高血压患者作为研究对象,随机分为对照组与观察组,各 100 例.对照组由专科医生制定和调整治疗方案,以及进行必要的诊疗干预,观察组在对照组基础上接受家庭药师服务干预.两组患者均随访 12 个月,在干预前、随访 6 个月及随访 12个月时采用欧洲五维度五水平健康量表(EQ-5D-5L)采集患者的健康数据并获得健康描述系统和视觉模拟量表(EQ-VAS)评分,再结合中国 EQ-5D-5L 效用积分体系表计算质量调整生命年(QALYs)作为效用指标;研究期间干预措施产生的费用作为成本指标,采用成本-效用分析法进行药物经济学评价.结果 与对照组比较,观察组直接医疗成本、间接成本以及总成本均较低,但差异无统计学意义(P＞0.05);对照组和观察组因发生心脑血管事件住院的分别为14例和6例;随访12个月时,观察组效用值和VAS评分明显高于对照组(P＜0.05);观察组效用值及VAS评分在随访 12 个月时均显著高于干预前(P＜0.05),对照组未见明显变化(P＞0.05);与对照组比较,观察组每增加 1 个QALY同时减少31 592.77 元的费用.结论 以药师为主导的居家药学服务模式对老年高血压患者有明确的经济学获益,降低治疗成本同时可改善其生命质量.
Abstract
Objective To evaluate the economic value of family pharmacist service for elderly patients with hypertension.Methods A total of 200 elderly hypertensive patients in Guicheng community,Nanhai District,Foshan City were selected as the study objects and randomly divided into control group and observation group,with 100 cases in each group.In the control group,the doctors made and adjusted the treatment plan,and carried out the necessary diagnosis and treatment intervention,the observation group received family pharmacist service intervention on the basis of the control group.All patients were followed up for 12 months.The health data and EQ-VAS scores were collected by using the modified European 5-Dimension Health Scale before intervention and at 6-month and 12-month follow-up,the quality adjusted life years(QALYs)were calculated as the utility index in combination with the China EQ-5D-5L utility score system;the cost of all interventions during the study is used as a cost indicator,cost-utility analysis method was used for pharmacoeconomic analysis.Results Compared with the control group,the direct medical cost,indirect cost and total cost of the observation group were lower,but the difference was not significant(P＞0.05);there were 14 cases and 6 cases in the control group and the observation group hospitalization due to cardiovascular and cerebrovascular events;at 12 months follow-up,the utility value and VAS score of the observation group were significantly higher than those of the control group(P＜0.05);the utility value and VAS score of the observation group were significantly higher than those before intervention(P＜0.05),while no significant change was found in the control group(P＞0.05);compared with the control group,the cost of each additional QALYs in the observation group decreased by 31 592.77 yuan.Conclusion Pharmacist-led home pharmaceutical care model has clear economic benefits for chronic disease management of elderly patients with hypertension,reducing the cost of treatment and improving their quality of life,which is worth promoting.
关键词
家庭药师/老年高血压/药物经济学评价Key words
Family pharmacist/Elderly hypertension/Pharmacoeconomic evaluation引用本文复制引用
基金项目
佛山市卫生健康局医学科研项目(20210338)
佛山市中医重点专科项目(十四五)(ZDZKJS45)
佛山市高水平医学重点专科项目(十四五)(FSGSP145088)
佛山市南海区重点专科项目(十四五)(南卫健[2021]211号)
佛山市中医药临床科技创新基地项目(佛卫函[2022]35号)
出版年
2024
国家科技期刊平台
NSTL
万方数据