中国药房2025，Vol.36Issue(9)：1129-1134,6.DOI:10.6039/j.issn.1001-0408.2025.09.19
家庭医生制度下药师参与脑卒中患者长期药物治疗管理模式实践及评价
Practice and evaluation of pharmacists'participation in long-term MTM models for stroke patients based on family doctor system
摘要
Abstract
OBJECTIVE To investigate the clinical efficacy of integrating pharmacists into family health teams(FHTs)for long-term medication therapeutical management(MTM)in stroke patients,and empirically evaluate the service model.METHODS A pharmacist team,jointly established by clinical and community pharmacists from the Affiliated Suzhou Hospital of Nanjing Medical University(hereinafter referred to as"our hospital"),developed a pharmacist-supported MTM model integrated into FHTs.Using a prospective randomized controlled design,170 stroke patients discharged from our hospital(July 2022-December 2023)and enrolled in FHTs at Suzhou Runda Community Hospital were randomly divided into trial group(88 cases)and control group(82 cases)according to random number table.The control group received routine FHTs care(without pharmacist involvement in the team collaboration),while the trial group received 12-month MTM services supported by pharmacists via an information platform.These services specifically included innovative interventions such as personalized medication regimen optimization based on the MTM framework,dynamic medication adherence management,medication safety monitoring,a home medication assessment system,and distinctive service offerings.Outcomes of the 2 grousp were compared before and after intervention,involving medication adherence(adherence rate,adherence score),compliance rates for stroke recurrence risk factors[blood pressure,low-density lipoprotein cholesterol(LDL-C)],and incidence of adverse drug reactions(ADR).RESULTS After 12 months,the trial group exhibited significantly higher medication adherence rates,improved adherence scores,higher compliance rates for blood pressure and LDL-C targets compared to the control group(P＜0.05).The incidence of ADR in the trial group(4.55%)was significantly lower than that in the control group(8.11%),though the difference was not statistically significant(P＞0.05).CONCLUSIONS Pharmacist involvement in FHTs to deliver MTM services significantly enhances medication adherence and optimizes risk factor for stroke recurrence,offering practical evidence for advancing pharmaceutical care in chronic disease management under the family doctor system.关键词
家庭医生制度/医院药师/社区药师/脑卒中/药学服务/药物治疗管理/用药依从性Key words
family doctor system/clinical pharmacist/community pharmacist/stroke/pharmaceutical care/medication therapeutical management/medication compliance分类
医药卫生引用本文复制引用
石璐,马雯,薛宏志,刘纯,唐莲,李静静,薛苏冬,虞燕霞,李雯雯,于可人,薛建辉..家庭医生制度下药师参与脑卒中患者长期药物治疗管理模式实践及评价[J].中国药房,2025,36(9):1129-1134,6.基金项目
江苏省药学会恒瑞药学服务专项科研项目(No.H202024) （No.H202024）
