保健医学研究与实践2025，Vol.22Issue(7)：107-114,8.DOI:10.11986/j.issn.1673-873X.2025.07.17
保护动机理论导向的类风湿关节炎患者药学服务模式构建及应用研究
Construction and application of a pharmacy service model for rheumatoid arthritis patients guided by protection motivation theory
摘要
Abstract
Objective To explore the effects of a pharmacy service model based on protection motivation theory(PMT)on dis-ease activity,medication adherence,and self-management level in patients with rheumatoid arthritis(RA),and to provide a reference for optimizing pharmacist-led chronic disease management.Methods 160 RA outpatients who attended the Ninth Peo-ple's Hospital of Chongqing from March to April 2024 were enrolled and randomized,80 per each.The intervention group received PMT-based pharmacy services,while the control group received routine pharmacy services.Changes in subscale scores of the PMT scale at different time points before and after the intervention were analyzed,and disease activity,self-management level,and medica-tion adherence were compared between groups before and after intervention.Meanwhile,the incidence of adverse drug reaction(ADR)in the two groups at different intervention time perioda was compared.Results A total of 141 patients completed three follow-ups(72 in the intervention group,69 in the control group).The PMT subscales of perceived susceptibility,perceived severity,self-efficacy and response efficacy were significantly positively correlated with Self-Management Behavior Scale scores and Morisky Medication Adherence Scale-8(MMAS-8)medication compliance scores,and significantly negatively correlated with Disease Activity Score in 28 Joints(DAS28;P＜0.05);by contrast,internal reward,external reward and response cost were significantly negatively correlated with Self-Management Behavior Scale scores and MMAS-8 scores,and significantly positively correlated with DAS28(P＜0.05).PMT subscale scores showed significant effects of time,group,and time-group interaction(P＜0.05).Before intervention,there were no significant differences between groups in PMT subscale scores(P＞0.05);at month 3,the intervention group outperformed the control group significantly on six PMT subscales(all except self-efficacy;P＜0.05),and at months 6 and 9,the intervention group's PMT subscale scores were superior to the control group's,with statistical significance(P＜0.05).There were no significant differences between groups in ADR incidence across the interven-tion periods(P＞0.05).Before intervention,DAS28,Self-Management Behavior Scale,and MMAS-8 scores did not differ significantly between groups(P＞0.05).After intervention,the intervention group showed significantly better DAS28,self-management,and MMAS-8 scores than the control group(P＜0.05);within-group comparisons showed the intervention group improved significantly on all three measures after intervention(P＜0.05),whereas the control group showed significant improvement only in the Self-Management Behavior Scale(P＜0.05).Conclusion PMT-based pharmacy services help RA pa-tients develop protective motivations,promote medication compliance and self-management levels,and reduce disease activity.This practice provides useful evidence for pharmacists to leverage their professional role in chronic disease management.关键词
类风湿关节炎/药学服务模式/保护动机理论/疾病活动度/自我管理水平Key words
Rheumatoid arthritis/Pharmacy service model/Protection motivation theory/Disease activity/Self-management level分类
临床医学引用本文复制引用
朱丽蓉,罗易,徐卫,刘锦,罗邵,石颖,贺雄..保护动机理论导向的类风湿关节炎患者药学服务模式构建及应用研究[J].保健医学研究与实践,2025,22(7):107-114,8.基金项目
重庆市卫生健康委医学科研项目(2024WSJK015). （2024WSJK015）
