| Objective: Taking patients with Parkinsonism as the research object,to explore a new pharmaceutical care model in chronic disease management based on the medical alliance of pharmacy specialists,and then providing a basis and reference for the further application and promotion of the model in chronic disease management.Methods: Based on the medical alliance of pharmacy specialist platform,a pharmaceutical care model was built led by pharmacists in tertiary hospitals,vertical linkage,and integrated inside and outside the hospital.A total of 100 patients with Parkinsonism treated in the neurology department of a tertiary hospital from January 2021 to May 2021 were selected and randomly divided into the control and experimental groups in a 1:1 ratio.The patients in the control group accepted routine medical services.The patients in the experimental group received management according to the pharmaceutical care model of the medical alliance of pharmacy specialists based on routine medical services.After 3 months and 6 months of intervention,the quality of life,clinical efficacy,incidence of adverse events,and medication compliance of the two groups of patients were compared and analyzed to evaluate the effect of this model.Results: A total of 100 Parkinsonism patients were included in the study,including 8cases who were lost to follow-up,3 cases who refused follow-up,and 2 cases who gave up treatment.Finally,42 cases were included in the experimental group and 45 cases in the control group.There were no statistical differences in gender,age,educational level,comorbidities,and other baseline characteristics between the two groups(P>0.05).After 3months of intervention,there was no significant difference in all observation indexes between the two groups(P>0.05).After 6 months of intervention,the median score on the quality of life scale in the experimental group was 3(IQR 2.0-5.0),lower than that in the same group before the intervention [4(IQR 2.0-7.0)] and in the control group [5(IQR2.0-8.5)],and the differences were discrepancy significant(Z=-2.533,P=0.011;Z=-2.386,P=0.017).The proportion of patients with high compliance(Morisky scale score 0)in the experimental group(73.81%)was higher than that in the control group(46.67%),and the difference was discrepancy significant(χ~2=6.656,P=0.010).The incidence of adverse events in the experimental group and the control group was 28.57% and 31.11%,respectively,and the median clinical efficacy scale scores were 30(IQR 25.00-39.50)and31.50(IQR 24.00-40.75),respectively,with no discrepancy differences(χ~2=0.067,P=0.796;Z=-0.455,P=0.649).Conclusion: After the pharmaceutical care model intervention based on the medical alliance of pharmacy specialists,the quality of life and medication obedience of Parkinsonism patients were improved.Moreover,the clinical efficacy and incidence of adverse events showed a trend of improvement.The home pharmacy service was better than telephone or outpatient service in improving the patients’ quality of life and compliance.Home pharmaceutical care was recognized by patients.The patients’ satisfaction was in favour of home pharmaceutical care.This study can provide a basis and reference for the promotion and application of "pharmaceutical service model based on medical alliance" in chronic disease management. |
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