0 . 0 5 。與質(zhì)控實施前組比較,質(zhì)控實施后組患者的日均治療總成本(16.26元vs.24.40元, P<0 . 0 0 1 )成本-效用比[23.12元/質(zhì)量調(diào)整生命年(QALY)vs.32.32元/QALY, P<0 . 0 0 1 小、一般的藥品不良反應(yīng)發(fā)生率( 2 . 5 0 % vs. 1 0 . 0 0 % P = 0 . 0 4 9 )均顯著降低,歐洲五維生存質(zhì)量量表效用值( 0 . 7 4 ± 0 . 0 6 Vs. 0 . 7 1 ± 0 . 0 7 , P = 0 . 0 0 3 ) 藥物治療相關(guān)問題減少數(shù)量(1.0個vs.0.5個, P<0 . 0 0 1 )用藥依從性評分[ ( 6 . 3 2 ± 0 . 4 8 ) 分vs. ( 6 . 1 0 ± 0 . 3 7 ) 分, P = 0 . 0 0 1 ] 和滿意度評分[ ( 9 2 . 5 6 ± 1 . 5 2 ) 分VS. ( 9 1 . 9 5 ± 1 . 5 6 ) 分, P=0 . 0 1 3 ? ]均顯著升高;兩組患者均未發(fā)生嚴重的藥品不良反應(yīng),新的藥品不良反應(yīng)發(fā)生率比較差異無統(tǒng)計學(xué)意義( 1 . 2 5 % vs. 3 . 7 5 % , P=0 . 3 1 0 ) 。結(jié)論藥學(xué)質(zhì)控可提高藥學(xué)服務(wù)工作質(zhì)量;ECHO模型可對MTM服務(wù)效果進行量化評價,使藥學(xué)服務(wù)更好計價,更能適應(yīng)社會需求,值得推廣。-龍源期刊網(wǎng)" />

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利用ECHO模型評價藥學(xué)質(zhì)控對藥物治療管理服務(wù)的影響

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中圖分類號R95 文獻標志碼A 文章編號 1001-0408(2025)09-1123-06

DOI 10.6039/j.issn.1001-0408.2025.09.18

ABSTRACT OBJECTIVE To evaluate the influenceof pharmaceutical quality control on the efficiency and outcomes ofstandardized medication therapy management(MTM) services for patients with coronary heart disease by using Economic,Clinical and Humanistic Outcomes(ECHO) model.METHODS This study collected case data of coronary

heart disease patients who received MTMservices during January-March 2O23(pre-qualitycontrol implementation group, n=9 6 ) and June-August 2023 (post-quality control implementation group, n=1 6 4 ). Using propensity score matching analysis,8O patients wereselectedfromeachgroup.Thestudysubsequentlycomparedtheeconomic,clinical,andhumanisticoutcomeindicatorsof pharmaceuticalservices betweethetwomatchedgroups.RESULTSTherewerenostatisticallysignificantdiferences inbaseline data between the two groups after matching ( P>0 . 0 5 ).Compared with pre-quality control implementation group,the daily treatment cost(16.26yuan vs.24.40 yuan, P<0 . 0 0 1 ),cost-effectiveness ratio [23.12 yuan/quality-adjusted life year(QALY)vs. 32.32 yuan/QALY, P<0 . 0 0 1 ],and the incidence of general adverse drug reactions ( 2 . 5 0 % vs. 1 0 . 0 0 % , P = 0 . 0 4 9 )of post-quality controlimplementation group weredecreasedsignificantly;theutilityvalueof theEuroQolFive-DimensionalQuestionaire( 0 . 7 4 ± 0.06 vs. 0 . 7 1 ± 0 . 0 7 , P=0 . 0 0 3 ) ,the reduction in the number of medication related problems(1.O vs.0.5, P<0 . 0 0 1 ),the medication adherence score ( 6 . 3 2 ± 0 . 4 8 ) points vs. ( 6 . 1 0 ± 0 . 3 7 ) points, P=0 . 0 0 1 ] ,and the satisfaction score [ ( 9 2 . 5 6 ± 1 . 5 2 ) points vs. ( 9 1 . 9 5 ± 1 . 5 6 ) points, P=0 . 0 1 3 ]all showed significant improvements. Neither group experienced serious adverse drug reactions.There was no statisticallysignificant difference inthe incidenceofnewadverse reactions between thetwo groups( 1 . 2 5 % (20號 vs. 3 . 7 5 % , P=0 . 3 1 0 ).CONCLUSIONS Pharmaceutical quality control can improve the qualityof pharmaceutical care,and the ECHO modelcanquantitativelyevaluate theeffectofMTMservices,making pharmaceuticalcarebeterpricedandmoreadaptable to social needs,thus being worthy of promotion.

KEYWORDSmedication therapy management;pharmaceuticalqualitycontrol;ECHO model;pharmaceutical care

藥物治療管理(medication therapeutical manage-ment,MTM)是指具有藥學(xué)專業(yè)技術(shù)的藥師為患者提供用藥教育、咨詢指導(dǎo)等一系列專業(yè)化服務(wù),旨在提高患者用藥依從性、降低用藥錯誤、優(yōu)化藥物治療方案,進而改善患者治療結(jié)局。(剩余8123字)

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