Pharmaceutical care of patients with heart failure
Pharmaceutical care of patients with heart failure
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DOI：
10.1111/j.1365-2125.2005.02387.x
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发表时间：
2005-08-01
影响因子：
3.4
通讯作者：
McElnay, JC
中科院分区：
文献类型：
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作者：
Sadik, A;Yousif, M;McElnay, JC
AimThe本研究的目的是调查药师主导的药学服务计划的影响，涉及优化药物治疗和强化教育和自我监测的心力衰竭（HF）患者在阿拉伯联合酋长国（UAE），在一系列的临床和人性化的结果measurements.MethodsThe研究是一个随机的，对照的，纵向的，前瞻性的临床试验在艾因医院，艾因，阿联酋。从普通内科病房、心脏科和内科门诊招募患者。确定符合入选标准且不存在排除标准的HF患者入选研究。招募后，患者被随机分配到两组之一：干预组或对照组。干预组患者接受结构化药学服务，对照组患者接受传统服务。当患者参加计划的门诊时，进行患者随访（每3个月）。每组共104例患者完成了试验（12个月）。患者一般患有轻度至中度HF（NYHA心功能1级，29.5%; 2级，50.5%; 3级，16%; 4级，4%）。（P < 0.05）一系列概括性结果指标[AUC]的改善（95%置信限）]，包括运动耐量[2分钟步行试验：1607.2（1474.9，1739.5）个月，干预患者vs. 1403.3（1256.5，1549.8），用力肺活量[31.6（30.8，32.4）1个月，干预患者vs. 27.8（26.8，28.9）对照组患者]，健康相关生活质量，通过明尼苏达心力衰竭生活问卷测量[463.5（433.2，493.9）单位月（干预组）vs. 637.5（597.2，677.7）单位月（对照组）;该指标评分越低，表明健康相关生活质量越好]。在最终评估（12个月）时，干预组中报告遵守处方药物的个体患者数量较高（P < 0.05）（85 vs. 35），遵守生活方式建议的个体患者数量也较高（75 vs. 29）。有一种倾向，有较高的发病率的干预患者的急诊科访问，但住院率较低。ConclusionsThe research提供了明确的证据表明，提供药物治疗HF患者可以导致显着的临床和人文的好处。
AimThe aim of this study was to investigate the impact of a pharmacist-led pharmaceutical care programme, involving optimization of drug treatment and intensive education and self-monitoring of patients with heart failure (HF) within the United Arab Emirates (UAE), on a range of clinical and humanistic outcome measures.MethodsThe study was a randomized, controlled, longitudinal, prospective clinical trial at Al-Ain Hospital, Al-Ain, UAE. Patients were recruited from the general medical wards and from cardiology and medical outpatient clinics. HF patients who fulfilled the entrance criteria, and had no exclusion criteria present, were identified for inclusion in the study. After recruitment, patients were randomly assigned to one of two groups: intervention group or control group. Intervention patients received a structured pharmaceutical care service while control patients received traditional services. Patient follow-up took place when patients attended scheduled outpatient clinics (every 3 months). A total of 104 patients in each group completed the trial (12 months). The patients were generally suffering from mild to moderate HF (NYHA Class 1, 29.5%; Class 2, 50.5%; Class 3, 16%; and Class 4, 4%).ResultsOver the study period, intervention patients showed significant (P < 0.05) improvements in a range of summary outcome measures [AUC (95% confidence limits)] including exercise tolerance [2-min walk test: 1607.2 (1474.9, 1739.5) m.month in intervention patients vs. 1403.3 (1256.5, 1549.8) in control patients], forced vital capacity [31.6 (30.8, 32.4) l.month in the intervention patients vs. 27.8 (26.8, 28.9) in control patients], health-related quality of life, as measured by the Minnesota living with heart failure questionnaire [463.5 (433.2, 493.9) unit.month in intervention patients vs. 637.5 (597.2, 677.7) in control patients; a lower score in this measure indicates better health-related quality of life]. The number of individual patients who reported adherence to prescribed medications was higher (P < 0.05) in the intervention group (85 vs. 35), as was adherence to lifestyle advice (75 vs. 29) at the final assessment (12 months). There was a tendency to have a higher incidence of casualty department visits by intervention patients, but a lower rate of hospitalization.ConclusionsThe research provides clear evidence that the delivery of pharmaceutical care to patients with HF can lead to significant clinical and humanistic benefits.