家庭醫(yī)生制度下藥師參與腦卒中患者長期藥物治療管理模式實踐及評價

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中圖分類號R95 文獻標志碼A 文章編號 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

腦卒中是危害我國人民健康的首要殺手，具有高發(fā)病率、高死亡率、高致殘率以及高復發(fā)率的特點。（剩余9884字）