中国临床药学杂志

目的 探讨临床药师在多学科联合管理模式下对痛风患者治疗依从性及血清尿酸达标率的影响。方法 选取2020年3月至2021年3月治疗的18岁以上痛风患者71例作为研究对象，分为试验组41例和对照组30例。组建一个多学科痛风管理小组，试验组在管理小组下进行为期32周的降尿酸治疗，对照组行常规治疗。比较2组患者治疗依从性及干预前后的血尿酸水平。结果 完成研究的患者共有61例，其中试验组35例，对照组26例。10例患者未完成研究。在治疗16周和32周时，2组患者血尿酸水平相较于基线均有明显下降(P <0.05)，且试验组显著低于对照组(P=0.021和P=0.048)；试验组分别有20例(57.1%)和21例(60.0%)患者血尿酸水平低于360μmol·L^-1，而对照组分别有7例(26.9%)和8例(30.8%)，组间差异有统计学意义(P <0.05)；试验组依从性评分为(29.1±8.9)分和(33.1±9.2)分，对照组分别为(16.1±5.1)分和(16.3±5.0)分，组间差异有统计学意义(P <0.05)。研究期间试验组和对照组干预药物不良反应分别为12例和3例，干预率分别为34.3%和11.5%(P <0.05)。试验组干预率高于对照组(P <0.05)。结论 临床药师参与多学科联合管理模式能使痛风患者治疗依从性和血尿酸达标率得到提高，血尿酸水平得到降低。

AIM To investigate the effect of clinical pharmacists participating in multi-disciplinary team(MDT management mode on compliance of therapy and standard reaching rate of serum uric acid in gout patients. METHODS A total of 71 gout patients treated in hospital from March, 2020 to March, 2021 were selected as study subjects, and were divided into control group(n = 30) and experiment group(n = 41). The patients in the experiment group were given urate-lowering therapy for 32 weeks under MDT, and the patients in the control group were treated with conventional therapy. The compliance of therapy and serum uric acid level of 2 groups before and after intervention were compared and analyzed. RESULTS The number of patients who finally completed the study was 61, among them, 35 in the experiment group and 26 in the control group. Ten patients did not complete the study. Compared with baseline, serum uric acid levels in 2 groups were significantly decreased at 16 and 32 weeks(P < 0.05). Serum uric acid levels in the experiment group were significantly lower than those in the control group at 16 and 32 weeks(P = 0.021 and P = 0.048). In the experiment group, uric acid levels were lower than 360 μmol·L^-1 in 20(57.1%) patients and 21(60.0%) patients at 16 and 32 weeks,respectively, while in the control group, uric acid levels were lower than 360 μmol·L^-1 in 7(26.9%) patients and 8(30.8%)patients, respectively, and the difference was statistically significant(P < 0.05). The compliance scores of the experiment group were(29.1 ± 8.9) points at 16 weeks and(33.1 ± 9.2) points at 32 weeks respectively, while the compliance scores of the control group at the same observation point were(16.1 ± 5.1) points and(16.3 ± 5.0) points respectively,with statistically significant differences between groups(P < 0.05). During the study period, there were 12 cases and 3cases of adverse drug reactions in the experiment group and the control group, and the intervention rate was 34.3% and 11.5%, respectively. The intervention rate in the experiment group was higher than that in the control group(P < 0.05).CONCLUSION The clinical pharmacists participating in MDT management mode is more effective than conventional treatment mode, and can improve the compliance of therapy, reduce the serum uric acid, and improve the standard reaching rate of serum uric acid in gout patients.