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目的探讨腹膜透析(PD)患者对药学服务需求的影响因素。方法选取2019年4月到2020年4月医院肾内科接诊的PD患者的调查数据进行回顾性分析。利用患者门诊复查的机会,现场填写《腹膜透析患者药学服务需求调研表》。对比"药学服务需求高"组与"药学服务需求不高"组的数据,依次通过单因素以及多因素的方法,分析PD患者对药学服务需求的独立影响因素。结果共有114例患者参与调查,有效回收问卷110份,有效回收率为96.49%。"药学服务需求高"组共有82例,"药学服务需求不高"组共有28例。年龄、受教育年限、透析时间、血压控制情况、合并使用药物种类、腹膜炎发病情况、用药依从性和对药物认知情况,均成为PD患者对药学服务需求的独立影响因素(OR=0.969、1.025、0.988、3.500、1.028、14.027、7.500、7.455,P <0.05)。结论包括患者年龄在内的多种因素均是PD患者对药学服务需求的独立影响因素,在工作中需要对这些因素进行有效干预,改善对该类患者提供的药学服务水平。
Abstract：AIM To explore the influencing factors of peritoneal dialysis(PD) patients' demand for pharmaceutical services. METHODS The survey data of peritoneal dialysis patients admitted to the Department of Nephrology of the Second Affiliated Hospital of Guangzhou Medical University from April 2019 to April 2020 were selected for retrospective analysis. By taking the opportunity of the patient's outpatient review the Survey Form of Pharmaceutical Care Needs for Peritoneal Dialysis Patients was filled in on the spot. The data of the "high demand for pharmaceutical care" group and the "low demand for pharmaceutical care" group were compared, and the independent influencing factors of PD patients' demand for pharmaceutical care were analyzed by the single-factor and multi-factor methods. RESULTS A total of 114 patients participated in the survey, and 110 questionnaires were effectively recovered, with an effective recovery rate of 96.49%. There were 82 patients in the "high demand for pharmaceutical services" group and 28 patients in the "low demand for pharmaceutical services" group. The age, years of education, dialysis time, blood pressure, drug used in combination, peritonitis incidence, medication compliance, and drug cognition had all become independent factors influencing the demand for pharmaceutical services for patients with peritoneal dialysis(OR=0.969, 1.025, 0.988, 3.500, 1.028, 14.027, 7.500 and 7.455, P < 0.05). CONCLUSION Various factors, including the age of the patients, are independent factors that influence the demand for pharmacy services for peritoneal dialysis patients. Some factors need to be effectively intervened in the work to improve the level of pharmaceutical care for such patients.
[1]张明珠,刘亚,金彬彬,等.影响腹膜透析相关性腹膜炎患者预后的相关因素分析[J].临床肾脏病杂志,2020,20(4):265.
[2]BENABED A,BECHADE C,FICHEUX M,et al.Effect of assistance on peritonitis risk in diabetic patients treated by peritoneal dialysis:report from the French Language Peritoneal Dialysis Registry[J].Nephrol Dial Transplant,2016,3 1(4):656.
[3]VAN DIEPEN A T, TOMLINSON G A,JASSAL S V.The association between exit site infection and subsequent peritonitis among peritoneal dialysis patients[J].Clin J Am Soc Nephrol,2012,7(8):1266.
[4]NUNEZ-MORAL M,SANCHEZ-ALVAREZ E,GONZALEZ-DIAZ I,et al.Exit-site infection of peritoneal catheter is reduced by theuse of polyhexanide.results of a prospective randomized trial[J].Perit Dial Int,2014,34(3):271.
[5]MUSHAHAR L,MEI L W,YUSUF W S,et al.Exit-site dressing and infection in peritoneal dialysis:a randomized controlled pilot trial[J].Perit Dial Int,2016,36(2):135.
[6]韩佳,杨荣荣,王来成.慢性肾脏病5期腹膜透析患者的药学监护[J].徐州医科大学学报,2019,39(10):771.
[7]丁跃辉,李伟,郑芳芳,等.构建区域共享的门诊药师参与的腹膜透析液物流配送服务模式[J].中国医院药学杂志,2020,40(1):117.
[8]刘盈,姜波,郭澄,等.国内外药师参与整合门诊的文献分析[J].中国药房,2020,31(6):740.
[9]中国医师协会肾脏内科医师分会,中国中西医结合学会肾脏疾病专业委员会.中国肾性高血压管理指南2016(简版)[J].中华医学杂志,2017,97(20):1547.
[10]MORISKY D E,GREEN L W,LEVINE D M.Concurrent and predictive validity of a self-reported measure of medication adherence[J].Med Care,1986,24(1):67.
[11]LI P K,CHOW K M,VAN DE LUIJTGAARDEN M W,et al.Changes in the worldwide epidemiology of peritoneal dialysis[J].Nat Rev Nephrol,2017,13(2):90.
[12] YU X,YANG X.Peritoneal dialysis in China:meeting the challenge of chronic kidney failure [J].Am J Kidney Dis,2015,65(1):147.
[13]REHMAN K A,BETANCOR J,XU B,et al.Uremic pericarditis,pericardial effusion,and constrictive pericarditis in end-stage renal disease:Insights and pathophysiology[J].Clin Cardiol,2017,40(10):839.
[14]PENG Y,YE H J,YI C Y,et al.Early initiation of PD therapy in elderly patients is associated with increased risk of death[J].Clin Kidney J,2021,14(6):1649.
[15]COMBET S, FERRIER M L,LANDSCHOOT M V, et al.Chronic uremia induces permeability changes,increased nitric oxide synthase expressio n,and structural modifications in the peritoneum[J].J Am Soc Nephrol,2001,12(10):2146.
[16] YE H,ZHOU Q,FAN L,et al.The impact of peritoneal dialysisrelated peritonitis on mortality in peritoneal dialysis patients[J].BMC Nephrol,2017,18(1):186.
[17]代瑞甫,蔡乐,朱曼,等.1例腹膜透析相关感染合并继发性甲状旁腺功能亢进患者的药学监护[J].中国药物应用与监测,2019,16(6):347.
[18]杨青,蔡宁,袁菱,等.1例腹膜透析相关性腹膜炎患者实施万古霉素血药浓度监测的药学实践[J].中国药物警戒,2019,16(11):683.
[19]GOLDFARB-RUMYANTZEV A S, BAIRD B C,LEYPOLDT J K,et al.The association between BP and mortality in patients on chronic peritoneal dialysis[J].Nephrol Dial Transplant,2005,20(8):1693.
[20]高芳,王少清,马欣,等.血压控制对腹膜透析终末期肾病患者残余肾功能及透析充分性的影响[J].解放军医药杂志,2020,32(4):64.
[21]CARTER B L,ARDERY G,DAWSON J D,et al.Physician and pharmacist collaboration to improve blood pressure control[J].Arch Intern Med,2009,169(21):1996.
[22]MASNOON N, SHAKIB S, KALISCH-ELLETT L,et al.What is polypharmacy?A systematic review of definitions[J].BMC Geriatr,2017,17(1):230.
[23]曾英彤,杨敏,伍俊妍,等.药学服务新模式:处方精简(Deprescribing)[J].今日药学,2017,27(6):390.
[24]吴婧倩,刘砚墨,杨颖昕.腹膜透析患者用药依从性及相关影响因素分析[J].实用药物与临床,2018,21(5):530.
[25]李连珍,赵建荣.影响腹膜透析患者依从性因素的调查与分析[J].中国血液净化,2016,15(7):377.
基本信息:
DOI：10.19577/j.1007-4406.2021.05.008
中图分类号:R95
引用信息:
[1]徐丹,冯霞,陈丽金,等.腹膜透析患者对药学服务需求的影响因素[J].中国临床药学杂志,2021,30(05):355-360.DOI:10.19577/j.1007-4406.2021.05.008.
基金信息:
广东省医院药学研究基金(编号2018LR05)
2021-09-25
2021-09-25