摘要
目的介绍医院产科医药联合门诊对妊娠期高血糖患者开展药物治疗管理(MTM)的服务模式与流程,总结实践效果,分析存在问题,为探索应用MTM管理提供参考。方法收集2021年1~6月大连市妇女儿童医疗中心(集团)体育新城院区产科医药联合门诊妊娠期高血糖患者信息,分析评估药物治疗相关问题,制定治疗计划,进行干预和随访。对患者的基本信息、药物治疗相关问题、血糖改善、用药依从性和糖尿病知识掌握等进行分析总结。结果实施MTM服务6个月,服务患者58例,人均服药(3.26±1.25)种,发现并解决药物治疗相关问题101个,人均随访(3.03±1.67)次。患者空腹血糖达到(4.83±0.36)mmol/L,餐后2 h血糖达到(6.30±0.39)mmol/L,对比干预前均得到控制。空腹血糖达标率由干预前44.83%上升到91.38%,餐后2 h血糖达标率由干预前29.31%上升到87.93%,血糖总体达标率达到86.21%。依从性问卷评分从干预前(5.64±1.63)分上升到(7.15±0.92)分,妊娠期高血糖知识评分从干预前(9.33±3.40)分上升到(13.55±3.26)分。结论产科联合门诊妊娠期高血糖患者MTM模式有利于患者的血糖管理,对提升治疗效果、解决患者用药问题、提升用药依从性、充分发挥药师作用具有积极意义。但仍存在表格手工填写、团队缺少多学科协作、患者对药师认知程度低等问题,还有待优化调整。
Objective To introduce the service mode and process of medication therapy management(MTM)for patients with hyperglycemia during pregnancy in the obstetrics and medicine combined outpatient service of our hospital,summarize the practical effects,analyze the existing problems,and provide reference for exploring the application of MTM.Methods The information of patients with hyperglycemia during pregnancy in the Obstetrics and Medicine Combined Outpatient Service of our hospital from January to June 2021 was collected to analyze and evaluate the problems related to medication therapy,formulate treatment plans,and conduct intervention and follow-up.Basic information of patients,problems related to medication therapy,improvement of blood glucose,medication compliance and knowledge acquisition of diabetes were analyzed and summarized.Results After 6 months of MTM service,58 patients were served,with an average of(3.26±1.25)kinds of drugs,101 problems related to medication therapy found and solved,and an average of(3.03±1.67)times of follow-up.Fasting blood glucose of the patients reached(4.83±0.36)mmol/L and 2 h postprandial blood glucose reached(6.30±0.39)mmol/L,both of which were controlled compared with those before intervention.The fasting blood glucose good control rate was increased from 44.83%before intervention to 91.38%;the 2 h postprandial blood glucose?good control rate was increased from 29.31%before intervention to 87.93%;the overall blood glucose good control rate reached 86.21%.The score of compliance questionnaire was increased from(5.64±1.63)points before intervention to(7.15±0.92)points,and the knowledge score of hyperglycemia during pregnancy was increased from(9.33±3.40)points before intervention to(13.55±3.26)points.Conclusion The MTM model is beneficial to blood glucose management of patients with hyperglycemia during pregnancy in the Obstetrics and Medicine Combined Outpatient Service,and has positive significance for improving therapeutic effect,solving medication problems of patients,improving medication compliance,and giving full play to the role of pharmacists.However,some problems still exist such as manual filling in the form,lack of multidisciplinary collaboration in the team,and low cognition level of patients to pharmacists,which need to be optimized and adjusted.
作者
赵文佳
李玲
徐秀华
张怡
郭铁建
ZHAO Wenjia;LI Ling;XU Xiuhua;ZHANG Yi;GUO Tiejian(Department of Pharmacy,Dalian Women and Children Medical Center(Group)Sports Xincheng Hospital Area,Dalian 116037,China;Department of Obstetrics Clinic,Dalian Women and Children Medical Center(Group)Sports Xincheng Hospital Area,Dalian 116037,China)
出处
《中国现代医生》
2022年第13期117-121,共5页
China Modern Doctor
基金
辽宁省大连市医学科学研究计划项目(2022012)。
关键词
药物治疗管理
妊娠期高血糖
妊娠糖尿病
药学服务
Medication therapy management(MTM)
Hyperglycemia during pregnancy
Gestational diabetes
Pharmaceutical care
