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目的提高社区癌痛患者疼痛控制达标率,改善患者对癌痛管理的满意度。方法组建由社区公共卫生服务人员、临床药师、社区医生以及追踪药师共同组成的照护团队,对社区癌痛患者开展药学服务,并对照护效果进行追踪评价。结果临床药师为17名中、重度癌痛患者提供药学服务52次,发现药物治疗问题224例,提出药学建议337条。接受药学服务后,患者过去24 h最严重的疼痛程度、最轻微的疼痛程度、平均的疼痛程度由(9.12±1.34),(5.53±1.46)和(7.24±1.99)分下降至(4.71±1.36),(1.18±0.95)和(2.41±1.18)分(P<0.01);用药“高依从性”患者比例由0%升至64.7%(P<0.01)。患者对药学服务能“帮助了解所用药品”、“协助按时用药”、“减少药品不良反应”、“帮助建立正确的用药观念”以及“减少医药花费”的评分依次为(4.35±0.49),(4.53±0.51),(4.00±0.61),(4.29±0.59)和(3.76±0.66)分;患者对“药学服务的方便性”、“药师能力”、“药师态度”、“病情改善”、“提高生活质量”的评分依次为(4.06±0.66)、(4.24±0.44)、(4.20±0.40)、(4.41±0.71)和(4.29±0.47)分。结论社区癌痛患者所面临的药物治疗问题多而复杂。药学服务可以减少药物治疗问题,提高疼痛控制达标率,改善患者对癌痛管理的满意度。患者对药学服务持肯定态度。
Objective To improve the control rate of pain control in community cancer patients and improve their satisfaction with cancer pain management. Methods A care team composed of community public health workers, clinical pharmacists, community doctors and follow-up pharmacists was established to carry out pharmacy services for community-based cancer patients and the follow-up evaluation was carried out. Results Clinical pharmacists provided pharmacological services for 17 patients with moderate and severe cancer pain for 52 times and found 224 drug treatment problems and proposed 337 pharmacological recommendations. After receiving the pharmacy service, the patients’ worst pain, the slightest pain and the average pain in the past 24 h dropped from (9.12 ± 1.34), (5.53 ± 1.46) and (7.24 ± 1.99) to (4.71 ± 1.36 ), (1.18 ± 0.95) and (2.41 ± 1.18) respectively (P <0.01). The proportion of patients with high compliance was increased from 0% to 64.7% (P <0.01). Patients could “help understand the drugs used”, “assist in the medication on time”, “reduce the adverse drug reactions”, “help establish the correct medication concept” and “reduce the medical expenses” for the pharmacy service The scores were (4.35 ± 0.49), (4.53 ± 0.51), (4.00 ± 0.61), (4.29 ± 0.59) and (3.76 ± 0.66) points, respectively. The patients had “convenience for pharmacy service” and "pharmacist ability (4.06 ± 0.66), (4.24 ± 0.44), (4.20 ± 0.40), (4.41 ± 0.71), (4) ) And (4.29 ± 0.47) points. Conclusion The treatment of community cancer patients is more and more complicated. Pharmacy services can reduce drug treatment problems, improve pain control compliance rates and improve patient satisfaction with cancer pain management. Patients hold a positive attitude toward pharmacy services.