利用ECHQO模型评价标准化药物治疗管理服务效果
Evaluation of the effectiveness of standardization medication therapy management services by ECHQO model
蒋欢欢 1刘坤 1谷秀林 2封锦慧 2王紫监3
作者信息
- 1. 华北理工大学附属医院药学部,河北唐山 063000
- 2. 河北北方学院附属第二医院药剂科,河北 张家口 075000
- 3. 河北北方学院附属第二医院心内科,河北 张家口 075000
- 折叠
摘要
目的:利用经济、临床、人文和质量产出ECHQO模型(economic clinical humanistic and quality outcomes model)评价冠心病患者实施标准化药物治疗管理(MTM)的服务效果.方法:126例冠心病患者随机分为观察组和对照组,各63例.对照组给予常规诊疗服务,观察组在此基础上增加标准化MTM服务,6个月后比较2种诊疗服务的经济、临床、人文和质量产出指标的差异.结果:入组时,2组收缩压、舒张压、药物治疗相关问题(MRPs)个数、用药依从性评分(Morisky评分)、满意度评分及冠心病健康知识知晓度评分比较差异无统计学意义(P＞0.05).末次随访时,观察组收缩压下降值、舒张压下降值、血压达标率、MRPs下降个数、Morisky评分、满意度评分、冠心病健康知识知晓度评分及仿制药使用占比均高于对照组(P＜0.01),冠心病住院率和非临床路径药品累计DDDs占比均低于对照组(P＜0.01);观察组成本低(4556元vs.9 654元)、效果好(收缩压下降:19.0 mmHg vs.10.0 mmHg;舒张压下降:8.7 mmHg vs.5.0 mmHg),为绝对优势方案,具有经济性.结论:冠心病患者实施标准化MTM服务,可提高临床和人文产出、降低治疗总成本、提高医疗质量,值得推广.
Abstract
OBJECTIVE To evaluate the effectiveness of standardization medication therapy management(MTM)services in patients with coronary heart disease(CHD)by ECHQO(economic,clinical,humanistic & quality outcomes)model.METHODS A total of 126 CHD patients were assigned into two groups of control and observation(n=63 each).Control group received routine medical care while observation group had additional standardization MTM services.After 6 months,economic,clinical,humanistic and quality outcome parameters were compared between 2 groups.RESULTS At the first follow-up,no sig-nificant inter-group differences existed in diastolic/diastolic blood pressure,number of medication related problems(MRPs),Morisky medication adherence scale,satisfaction score or CHD health awareness score.At the last follow-up,systolic/diastolic blood pressure drop,blood pressure standard rate,number of MRPs drop,Morisky scale,satisfaction score,CHD health aware-ness score and proportion of generic drug were higher in observation group than those in control group(P＜0.01).Hospitalization rate of CHD and proportion of cumulative DDDs of medicine nonclinical pathway were lower in observation group than those in control group(P＜0.01).As compared with control group,cost was lower in observation group(4 556 vs.9 654 yuan)and effec-tiveness was better(diastolic blood pressure drop:19.0 vs.10.0 mmHg;diastolic blood pressure drop:8.7 vs.5.0 mmHg),observation group was absolute advantage plan with economic advantages.CONCLUSION Standardization medication therapy management services in CHD patients may improve clinical and humanistic outcomes,lower total cost and optimize medical qual-ity.Wider popularizing is worthwhile.
关键词
药物治疗管理/冠心病/ECHQO模型/药学服务/经济学评价Key words
medication therapy management/coronary heart disease/ECHQO model/pharmaceutical care/economic evaluation引用本文复制引用
基金项目
河北省卫生健康委2020年政府资助临床医学人才培养项目(361-1104-JSN-2RDY)
出版年
2024
NETL
NSTL
万方数据