程慧 黄德红 王兵娥 郑俊敏

【摘要】 目的：建立慢病患者用药时间轴教育单，考察其对患者用药依从性和有效性的影响。方法：以2018年1-10月笔者所在医院心病科、内分泌科患者作为研究对象，将其分为对照组（n=65）和观察组（n=65），对照组接受传统医疗服务项目，观察组在此基础上增加用药时间轴教育单，比较两组患者入院期间和出院3个月随访时的用药依从性、用药偏差，以及6个月后的再入院次数及药物不良反应发生例数。结果：观察组出院3个月用药依从性显著高于对照组（P<0.01），观察组出院3个月用药偏差发生率和6个月后再入院次数、药物不良反应发生例数均明显低于对照组（P<0.01）。结论：临床药师以用药时间轴教育单对慢病患者开展药学服务，显著提高患者用药依从性，降低用药偏差，减少非预约再入院率和相关药物不良反应发生例数，用药时间轴教育单在慢病患者管理中起着重要作用。

【关键词】 用药时间轴教育单 用药依从性 药学服务 用药偏差 再入院率

doi：10.14033/j.cnki.cfmr.2019.30.078 文献标识码 B 文章编号 1674-6805（2019）30-0-03

[Abstract] Objective： To establish a medication timeline education list and investigate the influence of medication timeline education list in patients with drug safety and efficacy. Method： Taking the patients of cardiology and endocrinology in our hospital from January to October 2018 as the research object. Patients were divided into control group （n=65） and experimental group （n=65）. The control group received the traditional medical service program. On the basis of this， the experimental group increased the medication timeline education list. We compared medication adherence， medication bias， the number of readmissions after 6 months and the number of adverse drug reactions in the two groups at the time of admission and at the 3-month follow-up. Result： The medication adherence of the experimental group during admission and discharge for 3 months was significantly higher than that of the control group （P<0.01）. The incidence of medication deviation in the observation group， the number of readmissions after 6 months and the number of adverse drug reactions were significantly lower than the control group （P<0.01）. Conclusion： Clinical pharmacists use the medication timeline education list to provide pharmacy services to patients with chronic diseases， significantly improve patient compliance， reduce medication bias， and reduce non-reserved readmission rate. The medication timeline education list plays an important role in the management of chronically ill patients.

[Key words] Medication timeline education list Medication compliance Pharmaceutical service Medication bias Readmission rate

First-authors address： Traditional Chinese Medicine Hospital of Xiangyang， Xiangyang 441000， China

伴随人口老龄化的进展，慢性疾病发病人数和患病率均逐年上升，慢性病疾病已经成为危害人类健康的主要問题，慢性疾病包括多个病种如高血压、冠心病、脑梗死、糖尿病、慢性阻塞性肺部疾病等多种疾病[1]。慢性疾病患者需要长期口服药品，随着治疗时间的增长以及多种药物的联合使用，使得患者特别是老年患者容易混淆导致用药依从性降低，从而达不到临床治疗效果。

研究表明，临床药师参与慢病管理，提供药学服务可以改善患者预后与转归，对患者慢性病的发展有着极大的益处[2]。本院临床药师通过参与慢病管理，设计用药时间轴教育单，将患者所用药品以时间轴进行展示，时间轴以一天时间为横坐标，坐标轴主要分布5个坐标点即：晨起（6：00）、早餐前后（8：00）、中餐前后（12：00）、晚餐前后……