临床药师开展药物治疗管理的实践经验与成本-效益分析

Practical Experience and Cost-benefit Analysis of Clinical Pharmacists in Medication Therapy Management

关键词:  药学监护  药物治疗管理  临床药师  成本-效益分析

Key words:  pharmaceutical care  medication therapy management  clinical pharmacist  cost-benefit analysis

摘要:

目的 应用药物治疗管理（medication therapy management，MTM）的标准化流程为患者提供药学服务，通过成本-效益分析评价MTM是否具有经济学效益。方法 应用MTM模式对患者进行药学服务，记录患者一般情况，疾病、用药情况及药品费用，对患者的用药及生活方式问题，分析并提出行动计划，随访。成本-效益研究以MTM服务为成本，药品治疗费用的减少为效益，计算服务前后的成本-效益比。结果 临床药师对80例患者进行了MTM服务，最终完成59例，患者男女比例为39：20，平均年龄（62.39±15.75）岁，使用药物446种，人均（7.56±3.77）种，发现患者用药问题与生活问题255例并进行干预，干预成功率73.33%。服务前后用药成本分别作为2组进行统计分析，发现干预后用药费用明显低于干预前（P<0.05），成本-效益比值B/C=4.25>1。结论 临床药师开展MTM服务可以提高患者依从性，改善用药问题与生活方式，且为患者提供积极的经济学影响。

Abstract:

OBJECTIVE To evaluate whether medication therapy management(MTM) has economic benefits through cost-benefit analysis by apply standardized process of MTM to patients. METHODS Applying MTM service model in pharmaceutical care for patients, organizing and recording the general condition, the disease and medication situation, and the cost of medicine of patients, discovering and analyzing the patients' problem of using medicine and lifestyle, proposing the drug treatment plan. Finally, archiving and following up the patients' data. The cost was the cost of MTM services, the benefit indicator was the reduction of drug costs, and calculated the cost-benefit ratio before and after the service. RESULTS The clinical pharmacist performed MTM service on 80 patients, and finally completed 59 cases. The ratio of male to female was 39:20, the average age was (62.39±15.75) years old, using 446 kinds of drugs, and the average kinds of drugs were (7.56±3.77). Two hundred and fifty-five cases were intervened and the success rate of intervention was 73.33%. The cost of medication before and after service was statistically analyzed as two groups. It was found that the cost of medication after intervention was significantly lower than that before intervention(P<0.05), and the cost-benefit ratio was 4.25>1. CONCLUSION Clinical pharmacists' MTM services can improve patients' compliance, improve medication problems and lifestyle, and provide positive economic impact to patients.