中国药房2026，Vol.37Issue(6)：800-805,6.DOI:10.6039/j.issn.1001-0408.2026.06.18
临床药师基于临床药学路径参与慢性心力衰竭治疗的效果评价
Evaluation of the effect of clinical pharmacists participating in the treatment of chronic heart failure based on the clinical pharmacy pathway
摘要
Abstract
OBJECTIVE To evaluate the effect of clinical pharmacists participating in the treatment of chronic heart failure(CHF)based on the clinical pharmacy pathway(CPP).METHODS Totally 226 CHF patients recruited from August 24th,2024 to March 14th,2025,were divided into an observation group and a control group based on the random number table method,with 113 cases in each group.All patients were treated with conventional therapy.The observation group was additionally given CPP management(including pharmaceutical care during hospitalization,the formulation of individualized discharge medication regimens,and pharmaceutical follow-up after discharge).The cardiac function parameters at admission,at discharge,at 3 and 6 months after discharge,drug use at 6 months after discharge,economic indicators,as well as the readmission rate and mortality rate at 6 months after discharge were compared between the two groups.Morisky Medication Adherence Scale-8 Items(MMAS-8),Somatic Self-rating Scale(SSS)and Patient Health Questionnaire-9(PHQ-9)scores were compared at admission,at discharge and at 3 and 6 months after discharge.RESULTS Six months after discharge,24 patients dropped out.Eventually,104 patients in the observation group and 98 patients in the control group completed the study.Compared with at admission,New York Heart Association(NYHA)cardiac functional classification,left ventricular ejection fraction(LVEF)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)of both groups of patients at discharge as well as at 3 and 6 months after discharge were significantly improved;moreover,the improvements at 3 and 6 months after discharge were significantly better than those at discharge.Meanwhile,the above indexes(except for NYHA cardiac functional classification at discharge,NT-proBNP and NYHA cardiac functional classification at 3 months after discharge)of the observation group at discharge,at 3 and 6 months after discharge were significantly better than the control group(P＜0.05).The utilization rates of angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB)/angiotensin receptor neprilysin inhibitor(ARNI),the proportion of β-blockers reaching the target dose,the utilization rate of sodium-glucose linked transporter 2 inhibitor(SGLT2i),and the proportion of SGLT2i reaching the target dose in the observation group were significantly higher than the control group(P＜0.05),and the proportion of drugs and readmission rate were significantly lower than the control group(P＜0.05).Compared with at admission,MMAS-8 scores of the patients in the observation group at discharge,at 3 and 6 months after discharge were significantly increased,while SSS and PHQ-9 scores were significantly lowered(P＜0.05).And all the above scores gradually decreased with the extension of discharge time(P＜0.05).CONCLUSIONS Clinical pharmacists can utilize CPP to significantly improve patients'cardiac function,medication adherence,somatic symptoms and depression.Additionally,they can significantly improve the utilization rates of ACEI/ARB/ARNI and SGLT2i,as well as the proportion of target doses of β-blockers and SGLT2i,while simultaneously reducing readmission rates.关键词
慢性心力衰竭/临床药学路径/临床药师/个体化用药Key words
chronic heart failure/clinical pharmacy pathway/clinical pharmacist/individualized medication分类
医药卫生引用本文复制引用
侯冠华,王宝珍,唐雨晨,程杰,董媛,董志强..临床药师基于临床药学路径参与慢性心力衰竭治疗的效果评价[J].中国药房,2026,37(6):800-805,6.基金项目
北京医学奖励基金会课题(No.YXJV-2025-0106-0188) （No.YXJV-2025-0106-0188）
包头医学院科学研究基金项目(No.BYJJ-ZRQM202324) （No.BYJJ-ZRQM202324）
