临床药师开展用药教育对脑卒中患者二级预防及依从性的作用的随机对照研究

目的：探讨神经内科临床药师开展用药教育工作，对脑卒中患者用药二级预防及依从性的作用。方法：对北京某三甲医院2017年9月-2018年1月年住院的神经内科脑卒中患者进行随机分组，其中教育组进行系统的用药教育，对照组仅进行药品服用方法说明，于出院后3个月进行回访，详细询问患者的疾病预防情况、用药依从性、不良反应及服药与停药情况，并通过SPSS对数据进行统计分析。结果：总计纳入301名患者，其中教育组156例，对照组145例。最终完成试验272人，教育组139例，对照组133例。教育组病情好转121例，恶化及复发18例，其中死亡1例，对照组病情好转92例，恶化及复发41例，其中死亡2例，2组比较结果有显著性差异（P=0.001<0.05）；用药依从性方面，教育组自行停药37例、按疗程服药19例、进行药物监测89例，不规律用药56例，对照组自行停药44例、按疗程服药6例、药物监测61例，不规律用药49例，教育组用药依从性优于对照组；不良反应方面，教育组发生10例，对照组2例。结论：临床药师通过用药教育能够提高脑卒中患者用药依从性，对患者控制疾病，减少脑卒中的进展及复发有积极意义。

A randomized controlled trialon effect of drug education by clinical pharmacists on secondary prevention and compliance of stroke patients

OBJECTIVE To investigate the effect of education by clinical pharmacist of neurology on compliance and secondary prevention in patients with stroke.METHODS The patients in the department of neurology admitted in A-grade hospitals from September 2017 to January 2018 were randomly assigned. Patients in the education group had detailed drug education, and patients in the control group only had education on basic instructions for drug administration. After returning from the hospital for three months, patients in the two groups were asked about drug compliance, disease control, adverse reactions, and medication and drug withdrawal. The data were statistically analyzed by SPSS.RESULTS A total of 301 patients were covered, including 156 in the education group and 145 in the control group. 269 people completed the trial, 139 in the education group, and 133 in the control group. In the education group, 121 cases improved, 18 cases deteriorated or relapsed and 1 case died. In the control group, 92 cases improved, 41 cases deteriorated or relapsed and 2 cases died. There was a statistically significant difference between the two groups (P=0.001<0.05). In terms of compliance, the education group had 37 cases of self-stopping medicine, 19 cases of drug treatment, 89 cases of drug monitoring, and 56 cases of irregular drug use. In the control group, there were 44 cases of drug withdrawal, 6 cases of drug treatment, 61 cases of drug monitoring, and 49 cases of irregular drug use. The compliance of the education group was better than that of the control group. There were 10 cases of adverse reactions in the education group and 2 cases in the control group.CONCLUSION Clinical pharmacists can improve compliance of stroke patients through medication education, and have positive significance for disease control and reduction of stroke progression and recurrence.