家庭医生制度下药师参与脑卒中患者长期药物治疗管理模式实践及评价

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中图分类号R95 文献标志码A 文章编号 1001-0408（2025）09-1129-06

DOI 10.6039/j.issn.1001-0408.2025.09.19

ABSTRACTOBJECTIVEToinvestigatetheclinical eficacyof integrating pharmacists intofamily healthteams（FHTs）for long-termmedicationtherapeuticalmanagement （MTM）in stroke patients，andempiricallyevaluate theservice model.METHODS A pharmacistteam，jointlyestablishedbyclinicalandcommunitypharmacistsfromtheAfiliated Suzhou Hospitalof Nanjing MedicalUniversty（hereinaftereferrdtoas“ourhospital"），developedapharmacist-supportedMMmodelintegrateditoFHs. Usingaprospectiverandomizedcontrolleddesign，17Ostrokepatientsdischargedfromourhospital（July202-December 2023）

and enrolled in FHTs at Suzhou Runda Community Hospital wererandomlydivided into trial group（88 cases）and control group （82 cases） according to random number table. The control group received routine FHTs care（without pharmacist involvement in the team collaboration），while the trial group received 12-monthMTM services supportedbypharmacistsvia

aninformationplatform.Theseservicesspecificallyincludedinnovativeinterventionssuchaspersonalizedmedicationregimen optimization basedonthe MTM framework，dynamic medicationadherencemanagement，medication safety monitoring，a home medicationasessment system，and distinctiveserviceoferings.Outcomesof the2grousp werecomparedbeforeandafter intervention，involvingmedicationaderence（aderencerate，aherencescore），omplianceratesforstrokerecurenceriskfactors [blood pressure，low-densitylipoproteincholesterol（LDL-C）]，andincidenceofadversedrugreactions（ADR）.RESULTSAfter 12months，thetrialgroupexhibitedsignificantlyhighermedicationadherencerates，mprovedadherencescores，highrcompliance rates for blood pressure and LDL-C targets compared to the control group ⋅ P<0 . 0 5 ）. The incidence of ADR in the trial group 0 4 . 5 5 % ）was significantly lower than that in the control group （ 8 . 1 1 % ），though the difference was not statistically significant（ P > 0.05）.CONCLUSIONS Pharmacist involvement inFHTs todeliver MTMservices significantlyenhances medicationadherence and optimizesriskfactorforstrokerecurrence，oferingpracticalevidenceforadvancingpharmaceuticalcareinchronicdisease management under the family doctor system.

KEYWORDSfamilydoctorsystem；clinicalpharmacist；communitypharmacist；stroke；pharmaceuticalcare；medicatior therapeutical management；medication compliance

脑卒中是危害我国人民健康的首要杀手，具有高发病率、高死亡率、高致残率以及高复发率的特点。（剩余9884字）