社區(qū)慢性病老年人用藥安全及干預(yù)措施

夏杰+姜佳

【摘要】 目的 對(duì)社區(qū)慢性病老年人的用藥安全情況及相關(guān)干預(yù)措施予以探究。方法 138例患有慢性病且長(zhǎng)期服藥的老年患者， 隨機(jī)分為對(duì)照組與觀察組， 每組69例。其中對(duì)照組給予常規(guī)統(tǒng)一的藥物知識(shí)宣傳教育， 觀察組在對(duì)照組基礎(chǔ)上進(jìn)行深入隨訪， 對(duì)受訪老年人進(jìn)行有針對(duì)性的用藥指導(dǎo)， 對(duì)比分析兩組患者藥物認(rèn)知情況、用藥依從性及用藥療效。結(jié)果 干預(yù)后， 兩組患者的藥物認(rèn)知情況較干預(yù)前均顯著改善， 且觀察組患者的藥物認(rèn)知情況顯著優(yōu)于對(duì)照組， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。干預(yù)后， 兩組患者的用藥依從性均顯著高于干預(yù)前， 且觀察組患者的用藥依從性顯著高于對(duì)照組， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組患者用藥后的治療總有效率（95.65%）顯著高于對(duì)照組（82.61%）， 差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 對(duì)社區(qū)慢性病老年患者予以深入宣傳教育與隨訪， 有針對(duì)性地對(duì)其進(jìn)行用藥指導(dǎo)， 可顯著改善用藥安全情況， 增強(qiáng)藥物療效。

【關(guān)鍵詞】 慢性病；老年人；用藥安全；干預(yù)措施

DOI：10.14163/j.cnki.11-5547/r.2017.29.088

【Abstract】 Objective To investigate the medication safety of senile patients with chronic diseases in community and its related intervention measures. Methods A total of 138 senile patients with chronic disease and long-term medication were randomly divided into control group and observation group， with 69 cases in each group. The control group received conventional unified knowledge of drug education， and the observation group also received targeted medication guidance on the basis of the control group during follow-up. Comparative analysis were made on drug cognition， medication compliance and medication efficacy between two groups. Results After intervention， both groups had better drug cognition than before intervention， and the observation group had better drug cognition than the control group. Their difference was statistically significant （P<0.05）. After intervention， both groups had obviously higher medication compliance than before intervention， and the observation group had obviously higher medication compliance than the control group. Their difference was statistically significant （P<0.05）. The observation group had obviously higher total treatment effective rate after medication （95.65%） than the control group （82.61%）， and the difference was statistically significant （P<0.05）. Conclusion For senile patients with chronic diseases in community， depth publicity and education and follow-up， and targeted medication guidance can significantly improve the safety of medication and enhance the efficacy of drugs.

【Key words】 Chronic diseases； Senile； Medication safety； Intervention measures

慢性病一般具有長(zhǎng)期性， 且難自愈， 以心腦血管類疾病或糖尿病等較為常見(jiàn)， 且此類疾病多發(fā)于老年人， 是造成其活動(dòng)不便甚至死亡的一類重要因素[1， 2]。另一方面， 患有慢性病的老年人多需長(zhǎng)期用藥， 但因其對(duì)相關(guān)藥物的選擇與使用等方面認(rèn)識(shí)不足， 無(wú)法保證用藥過(guò)程的安全性， 同時(shí)也不利于藥物療效的充分發(fā)揮， 故對(duì)其進(jìn)行科學(xué)有效的用藥指導(dǎo)， 對(duì)提升用藥療效、保障用藥安全具有重要意義。

1 資料與方法

1. 1 一般資料 選取2015年1月～2016年12月某社區(qū)患有慢性病且長(zhǎng)期服藥的老年患者138例， 隨機(jī)分為對(duì)照組與觀察組， 每組69例。對(duì)照組中男37例， 女32例；年齡63～87歲， 平均年齡（75.23±4.15）歲。觀察組中男39例， 女30例；年齡62～85歲， 平均年齡（74.91±4.37）歲。兩組患者一般資料比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）， 具有可比性。所選患者均為意識(shí)清晰且可自主服藥者， 而思維不清、有癡呆跡象、存在嚴(yán)重認(rèn)知障礙或精神疾病類患者均不在此項(xiàng)研究之列[1]。e……