阅读说明：本技术 一种老年慢性疾病用药监测记录方法 (Method for monitoring and recording medication of chronic diseases of old people ) 是由 周后凤 左晓 薛雨晨 马藏 于 2020-05-27 设计创作，主要内容包括：本发明公开了一种老年慢性疾病用药监测记录方法,属于疾病用药监测记录方法技术领域,无论是从医院角度还是从患者角度来看,药学的工作模式转向药学服务,药师从医院走进社区走进家庭都在很大程度上提高了老年慢性病患者的安全用药意识,充分发挥了药师保障患者安全用药的重要性,应用精细化药师干预不仅提高了老年慢性患者的合理用药性,还提高了患者对药师的认可和满意,提高了患者的经济效益和社会效益；这也是应用精细化药师干预模式促进药师转型的必要性和必然性。(The invention discloses a method for monitoring and recording medication of an elderly chronic disease, which belongs to the technical field of disease medication monitoring and recording methods, and has the advantages that the working mode of pharmacy is switched to pharmacy service no matter from the perspective of a hospital or a patient, a pharmacist walks from the hospital to a community and into a family, the safe medication consciousness of the elderly chronic disease is improved to a great extent, the importance of the pharmacist in guaranteeing the safe medication of the patient is fully exerted, the reasonable medication property of the elderly chronic disease is improved by applying refined pharmacist intervention, the approval and satisfaction of the patient to the pharmacist are also improved, and the economic benefit and the social benefit of the patient are improved; this is also the necessity and necessity to apply refined pharmacist intervention patterns to facilitate pharmacist transformation.)

1. A method for monitoring and recording the medication of chronic diseases of the old is characterized in that: the method comprises the following steps:

step 1: 200 elderly chronic patients are selected, and 200 elderly people are divided into 100 cases of experimental groups and control groups respectively by a random drawing method;

step 2: the patients in the control group adopt a common pharmacist intervention mode, and meanwhile, tools for improving the medication compliance are provided;

and step 3: the experimental group is subjected to precise pharmacist intervention based on a common pharmacist intervention mode and provided by pharmacist fine management;

and 4, step 4: in step 3, the fine management intervention of the pharmacist comprises the steps of adopting a questionnaire preparation method, a DISC character testing method and a Delphi method;

and 5: after an intervention mode is established, intervention is carried out, a linkage service mode is established with a community, a family pharmacist is signed, and blood pressure, blood sugar and blood fat monitoring, anticoagulation monitoring of patients with atrial fibrillation, monitoring of antibacterial drug use and life style monitoring are carried out;

step 6: based on the step 5, further performing intervention drug dose adjustment, patient education, drug efficacy evaluation, personalized medication suggestion for a doctor, timely reporting drug-related adverse reactions and performing follow-up visit and propaganda and education at regular intervals;

and 7: comparing the medicine taking quantity, the medicine taking compliance, the medicine taking knowledge, the adverse reaction occurrence and the change of the hospitalization or hospitalization condition before and after intervention of the community elderly chronic disease patients after intervention;

and 8: statistical analysis of the data was performed using SPSS22.0 statistical software.

2. The method for monitoring and recording the medication of the elderly with chronic diseases as claimed in claim 1, wherein: the questionnaire preparation method in the step 4 is designed on the basis of consulting related documents, expert consultation and credibility analysis and combining the current situation of the community, the questionnaire consists of three parts, namely general data survey, medication condition survey and quality of life survey (EQ-5D), and the basic data part comprises name, gender, age, medical insurance condition, education level and living condition; the part of the investigation of the drug treatment condition comprises the disease condition, the conventional drug administration condition in about 3 months, the occurrence condition of adverse drug reactions, the investigation condition of drug compliance, the medical service utilization and medical expense condition in about 3 months, the evaluation of the health condition, and the investigation of the health condition and the quality of life of patients by adopting the European five-dimensional health table (EQ-5D).

3. The method for monitoring and recording the medication of the elderly with chronic diseases as claimed in claim 1, wherein: the DISC character test method in the step 4 can obtain a group A (dominant character and influence character), a group C (dominant character and obedience character), a group D (influence character and robustness character), a group F (robustness character and obedience character), no statistical significance (P > 0.05), a group B (dominant character and robustness character), and a group E (influence character and obedience character), wherein the two groups have statistical significance (P <0.05), and the evaluation results of students with the colors of the 'influencing character' and the 'robust character' are referred to and the students with the colors of the 'dominant character' and the 'obedience character' are compared with each other by a questionnaire survey and a chi 2 test.

4. The method for monitoring and recording the medication of the elderly with chronic diseases as claimed in claim 1, wherein: in the step 4, the Delphi method establishes an all-dimensional and multi-angle patient reasonable medication evaluation model, determines evaluation subjects and evaluation index weights, divides index grading, and constructs a reasonable medication evaluation index system comprising 1 evaluation subject, 1 primary index and 5 secondary indexes.

5. The method for monitoring and recording the medication of the elderly with chronic diseases as claimed in claim 4, wherein: the Delphi method takes a patient as an evaluation subject, the first-level index is hospitalization experience, and the second-level index is the change of the number of medicines, the change of medication compliance, the change of medication guidance condition, the condition of adverse reaction of medicines and the condition of hospitalization or admission before and after intervention.

6. The method for monitoring and recording the medication of the elderly with chronic diseases as claimed in claim 1, wherein: wherein the change of the number of medicines used by the patient after the normal intervention and the refined intervention in the experimental group and the control group in the step 1 has no significant difference in the change of the number of medicines used compared with the normal intervention.

Technical Field

The invention relates to a disease medication monitoring and recording method, in particular to a method for monitoring and recording chronic diseases of the elderly, belonging to the technical field of disease medication monitoring and recording methods.

Background

With the development of economy and society, the aging process of population is accelerated, the incidence of chronic diseases such as hypertension, diabetes, coronary heart disease, chronic obstructive pulmonary disease and the like is gradually increased, the health and reasonable medication problems of the old people become the focus of social attention, at present, the old population in the community medication population of China accounts for more than 90%, many community old chronic patients often buy medicines in nearby drugstores for self-medication by themselves, unsafe factors of medication are further increased due to the lack of medicine related knowledge and effective medication guidance or medication consultation, the unreasonable medication problem is more prominent, and more attention needs to be paid by medical workers urgently.

In order to improve the reasonable medication of the chronic diseases of the old, thereby improving the medication compliance and the self-care ability of daily life of patients and bringing greater economic benefit and social benefit to the patients, therefore, a reasonable pharmacist intervention mode is searched to solve the problem that the reasonable medication of the old is urgently solved, and a method for monitoring and recording the medication of the chronic diseases of the old is designed to optimize the problems.

Disclosure of Invention

The invention mainly aims to provide a method for monitoring and recording the medication of the chronic diseases of the elderly, the working mode of pharmacy is switched to pharmacy service from the perspective of a hospital or a patient, and a pharmacist walks from the hospital to the community and into a family, so that the safe medication consciousness of the chronic disease patients of the elderly is improved to a great extent, and the importance of the pharmacist in ensuring the safe medication of the patients is fully exerted.

By applying refined pharmacist intervention, the reasonable drug use property of the elderly chronic patients is improved, the approval and satisfaction of the patients to the pharmacists are also improved, and the economic benefit and the social benefit of the patients are improved; this is also the necessity and necessity to apply refined pharmacist intervention patterns to facilitate pharmacist transformation.

A refined pharmacist intervention mode is applied, a family contract pharmacist is used for guiding a patient to take medicine one by one, reasonable medicine taking of the elderly chronic patients can be really improved, but due to the limitation of the number of personnel in the team, the amount of obtained effective samples is limited, and improvement is needed in many works to play a great role of the family pharmacist; this team of later stage will with hospital's business, united community cultivates the pharmacist of community to cooperate with general practitioner, manage the patient of community jointly, provide the biggest help for the patient rationally uses medicine.

The purpose of the invention can be achieved by adopting the following technical scheme:

a method for monitoring and recording the medication of chronic diseases of the old comprises the following steps:

step 1: 200 elderly chronic patients are selected, and 200 elderly people are divided into 100 cases of experimental groups and 100 cases of control groups by a random drawing method;

step 2: the patients in the control group adopt a common pharmacist intervention mode, and meanwhile, tools for improving the medication compliance are provided;

and step 3: the experimental group is subjected to precise pharmacist intervention based on a common pharmacist intervention mode and precise management of pharmacists;

and 4, step 4: in step 3, the fine management intervention of the pharmacist comprises the steps of adopting a questionnaire preparation method, a DISC character testing method and a Delphi method;

and 5: after an intervention mode is established, intervention is carried out, a linkage service mode is established with a community, a family pharmacist is signed, and blood pressure, blood sugar and blood fat monitoring, anticoagulation monitoring of patients with atrial fibrillation, monitoring of antibacterial drug use and life style monitoring are carried out;

step 6: based on the step 5, further performing intervention drug dose adjustment, patient education, drug efficacy evaluation, personalized medication suggestion presentation to a doctor, timely reporting of drug-related adverse reactions, and regular follow-up visit and propaganda;

and 7: comparing the medicine taking quantity, medicine taking compliance, medicine taking knowledge, adverse reaction occurrence and hospitalization or hospitalization condition change before and after intervention of the community elderly chronic disease patients after intervention;

and 8: statistical analysis of the data was performed using SPSS22.0 statistical software.

Preferably, the questionnaire preparation method in the step 4 is designed on the basis of consulting related documents, expert consultation and information effectiveness degree analysis and combining the current situation of the community, the questionnaire consists of three parts, namely general data survey, medical treatment condition survey and quality of life survey (EQ-5D), and the basic data part comprises name, sex, age, medical insurance condition, education level and living condition; the part of the investigation of the drug treatment condition comprises the disease condition, the conventional drug administration condition in about 3 months, the occurrence condition of drug adverse reaction, the investigation condition of drug compliance, the medical service utilization and medical expense condition in about 3 months, the evaluation of the health condition, and the investigation of the health condition and the quality of life of the patient by adopting the European five-dimensional health table (EQ-5D).

Preferably, the DISC character test method in step 4 passes questionnaire survey and x 2 test, and group a (dominant character and influential character), group C (dominant character and obedientic character), group D (influential character and robust character), group F (robust character and obedientic character), no statistical significance (P > 0.05), group B (dominant character and robust character), and group E (influential character and obedientic character) are two groups with statistical significance (P <0.05), and the evaluation results of trainees and trainees who refer to the colors of the "influential character" and the "robust character" are compared with the trainees who refer to the colors of the "dominant character" and the "obedientic character" in comparison.

Preferably, the delphi method in step 4 is to establish an all-dimensional and multi-angle patient rational medication evaluation model, determine evaluation subjects and evaluation index weights by the model, divide index grading, and construct a rational medication evaluation index system including 1 evaluation subject, 1 primary index and 5 secondary indexes.

Preferably, the patient is taken as an evaluation subject by the Delphi method, the first-level index is the hospitalization experience, and the second-level index is the change of the medicine dosage, the change of the medicine compliance, the change of the medicine instruction condition, the medicine adverse reaction condition and the hospitalization or hospitalization condition before and after intervention.

Preferably, the change of the dose of the patients with the normal intervention and the refined dry prognosis in the experimental group and the control group in the step 1 has no significant difference in the change of the dose of the medicines compared with the normal intervention in the refined dry prognosis.

The invention has the beneficial technical effects that:

according to the monitoring and recording method for the medication of the chronic diseases of the elderly, the working mode of pharmacy is switched to pharmacy service from the perspective of a hospital or a patient, and a pharmacist walks from the hospital to the community and into a family, so that the safety medication consciousness of the chronic disease of the elderly is improved to a great extent, and the importance of the pharmacist for ensuring the safe medication of the patient is fully exerted. The application of the intervention of the refined pharmacist not only improves the reasonable drug property of the elderly chronic patients, but also improves the approval and satisfaction of the patients to the pharmacist, and improves the economic benefit and the social benefit of the patients; this is also the necessity and necessity to apply refined pharmacist intervention patterns to facilitate pharmacist transformation.

A refined pharmacist intervention mode is applied, a family contract pharmacist is used for guiding a patient to take medicine one by one, reasonable medicine taking of the elderly chronic patients can be really improved, but due to the limitation of the number of personnel in the team, the amount of obtained effective samples is limited, and improvement is needed in many works to play a great role of the family pharmacist; this team of later stage will with hospital's business, united community cultivates the pharmacist of community to cooperate with general practitioner, manage the patient of community jointly, provide the biggest help for the patient rationally uses medicine.

Detailed Description

In order to make the technical solutions of the present invention more clear and definite for those skilled in the art, the present invention is further described in detail with reference to the following examples, but the embodiments of the present invention are not limited thereto.

The method for monitoring and recording the medication of the chronic diseases of the old comprises the following steps:

step 1: 200 elderly chronic patients are selected, and 200 elderly people are divided into 100 cases of experimental groups and 100 cases of control groups by a random drawing method;

step 2: the patients in the control group adopt a common pharmacist intervention mode, and meanwhile, tools for improving the medication compliance are provided;

and step 3: the experimental group is subjected to precise pharmacist intervention based on a common pharmacist intervention mode and precise management of pharmacists;

and 4, step 4: in step 3, the fine management intervention of the pharmacist comprises the steps of adopting a questionnaire preparation method, a DISC character testing method and a Delphi method;

and 5: after an intervention mode is established, intervention is carried out, a linkage service mode is established with a community, a family pharmacist is signed, and blood pressure, blood sugar and blood fat monitoring, anticoagulation monitoring of patients with atrial fibrillation, monitoring of antibacterial drug use and life style monitoring are carried out;

step 6: based on the step 5, further performing intervention drug dose adjustment, patient education, drug efficacy evaluation, personalized medication suggestion presentation to a doctor, timely reporting of drug-related adverse reactions, and regular follow-up visit and propaganda;

and 7: comparing the medicine taking quantity, medicine taking compliance, medicine taking knowledge, adverse reaction occurrence and hospitalization or hospitalization condition change before and after intervention of the community elderly chronic disease patients after intervention;

and 8: statistical analysis of the data was performed using SPSS22.0 statistical software.

In the embodiment, the questionnaire compiling method in the step 4 is designed on the basis of consulting related documents, private consultation and information effectiveness degree analysis and combining the current situation of the community, the questionnaire consists of three parts, namely general data survey, medical treatment condition survey and quality of life survey (EQ-5D), and the basic data part comprises name, sex, age, medical insurance condition, education level and living condition; the part of the investigation of the drug treatment condition comprises the disease condition, the conventional medication condition in about 3 months, the occurrence condition of adverse drug reactions, the investigation condition of medication compliance, the utilization of medical services and the expenditure condition of medical expenses in about 3 months, the evaluation of the health condition, and the investigation of the health condition and the quality of life of patients by adopting a European five-dimensional health table (EQ-5D).

TABLE 1 questionnaire for rational medication basic conditions of senile chronic diseases

In the present example, the DISC character test method in step 4 passes through questionnaire and χ 2 test, and group a (dominant character and influential character), group C (dominant character and obediential character), group D (influential character and robust character), group F (robust character and obediential character), no statistical significance (P > 0.05), group B (dominant character and robust character), and two groups E (influential character and obediential character), which have statistical significance (P <0.05), are obtained, and the evaluation results of the trainees with trainees who refer to the colors of "influential character" and "robust character" and the trainees with colors of "dominant character" and "obediential character" are compared.

In this embodiment, the delphi method in step 4 is to establish an all-dimensional and multi-angle patient rational medication evaluation model, determine an evaluation subject and evaluation index weights, divide index grading, and construct a rational medication evaluation index system including 1 evaluation subject, 1 primary index and 5 secondary indexes, where the delphi method uses a patient as an evaluation subject, the primary index is medical experience, and the secondary indexes are medical quantity change, medication compliance change, medication guidance condition change, adverse drug reaction condition, and medical condition before and after intervention or hospitalization condition.

Table 2. reasonable medication evaluation index system of medical institution constructed based on Delphi method

In this example, the change in the amount of drug administered to patients after the general intervention and the refined intervention in step 1 did not significantly differ from the change in the amount of drug administered in the refined drug intervention compared to the general intervention.

TABLE 3200 cases of the change of the number of medication (n) after the general and fine interventions for elderly patients with chronic diseases

In the actual investigation experiment, the test results of the test were,

TABLE 4200 patients with chronic senile diseases with different pharmacological interventions followed by drug compliance change (n)

2 comparing the knowledge of the patients with refined dry prognosis on the medicine administration knowledge, the refined medicine dry prognosis receives the medication guide, the patients with knowledge on the used medicine are obviously more than the ordinary intervention, and the difference has statistical significance (P < 0.01). See table 5.

Table 5200 cases of senile chronic patients receiving medication guidance after different pharmaceutical interventions (n)

Compared with the adverse reaction occurrence conditions of the patients after the general intervention and the refined intervention, the adverse reaction occurrence conditions of the patients after the general intervention and the refined intervention have no statistical significance (P is more than 0.05) in the aspects of skin pruritus and rash, dizziness and headache; in the aspect of gastrointestinal reaction and other adverse reactions, the number of cases after refined pharmaceutical intervention is obviously lower than that of common intervention, and the difference has significant statistical significance (P < 0.01). See table 6.

TABLE 6200 comparison of adverse drug reactions after different pharmacological interventions in elderly patients with chronic diseases (n)

Compared with the ordinary intervention, the ordinary intervention and the refined intervention have statistical significance on the condition that the patient is hospitalized again or admitted to the hospital after the refined pharmaceutical intervention, and the daily life capacity condition, the patient is hospitalized again or admitted to the hospital after the refined pharmaceutical intervention, and the ordinary intervention. See table 8.

TABLE 8200 comparison of the different dry-pharmaco-procedural prognosis for hospitalization or admission for elderly patients with chronic diseases (n)

The above description is only for the purpose of illustrating the present invention and is not intended to limit the scope of the present invention, and any person skilled in the art can substitute or change the technical solution of the present invention and its conception within the scope of the present invention.