中国临床药学杂志

目的 探讨基于欧洲医药保健网（PCNE）分类系统的药物治疗管理（MTM）对围绝经期综合征患者的应用效果。方法选取2021年9月至2022年3月门诊就诊的围绝经期综合征患者118例，根据患者治疗意愿分为对照组（53例）和研究组（65例），对照组予常规激素替代治疗（HRT）和临床药师用药指导，研究组予常规HRT和基于PCNE分类系统的MTM。根据PCNE分类系统对2组的药物相关问题（DRPs）进行识别和分析，并对研究组发生的DRPs进行干预。分别采用Morisky用药依从性量表和Kupperman改良评分评估干预1个月、3个月和12个月后患者的用药依从性和围绝经期综合征症状改善情况；比较2组HRT时间。结果 干预3个月和12个月后，研究组Kupperman改良评分均低于对照组（P<0.05）。干预1个月、3个月和12个月后，研究组Morisky用药依从性量表得分均高于对照组（P<0.05）；研究组HRT时间长于对照组（P<0.05）。干预期间，研究组发生DRPs的患者例数占比低于对照组（P<0.01），临床药师提出的干预措施中有88.09%被医师或患者完全接受或部分接受，86.05%的DRPs得到完全解决或部分解决。结论 基于PCNE分类系统的MTM可以改善围绝经期综合征患者的用药依从性，提高HRT疗效，减少DRPs的发生，并能有效解决治疗过程中发生的DRPs，保障患者用药的安全性和有效性。

AIM To investigate the efficacy of the Pharmaceutical Care Network Europe(PCNE) classification system in medication therapy management(MTM) for women with climacteric syndrome. METHODS From September 2021 to March 2022, 118 outpatients with climacteric syndrome were recruited and divided into control group(n = 53) and intervention group(n = 65), according to their treatment preference. The control group was given conventional hormone replacement therapy(HRT) and clinical pharmacist medication guidance. In addition to the treatment received by the control group, the study group was provided with MTM based on the PCNE classification system. The drug-related problems(DRPs) in both groups were identified and analyzed according to the PCNE classification system. However, interventions for DRPs were only implemented in the study group. While types and causes of DRPs were discriminatory analyzed in 2 groups, pharmaceutical interventions about DRPs in the intervention group were carried out and taken notes. The Morisky Adherence Scale and the modified Kupperman index were used to assess medication adherence and the improvement of climacteric syndrome symptoms after 1, 3, and 12 months of intervention, respectively. The duration of HRT in 2 groups was also compared. RESULTS The intervention group showed significantly higher medication compliance at 3 and 12 months and better treatment outcomes at 1, 3, and12 months(P < 0.05). The duration of HRT in the intervention group exceeded that in the control group(P < 0.05).During the intervention period, the intervention group demonstrated a significantly lower incidence of DRPs than the control group(P < 0.05). Approximately 88.09% of the intervention measures suggested by clinical pharmacists were fully or partially accepted by physicians and patients, leading to the successful resolution or partial resolution of about 86.05% of DRPs. CONCLUSION MTM based on the PCNE classification system could enhance medication adherence in patients with climacteric syndrome, optimize the effectiveness of HRT, mitigate the occurrence of DRPs,and effectively address any DRPs that may arise during treatment to ensure patient safety and therapeutic efficacy.