摘要
目的:构建老年缺血性脑卒中病人居家多重用药安全管理方案并验证其有效性。方法:选取2023年6月—11月于苏州市某三级甲等医院老年医学科和神经内科住院的253例老年缺血性脑卒中多重用药病人为研究对象。根据就诊时间将2023年6月—8月住院的病人分为对照组(n=128),9月—11月住院的病人分为试验组(n=125)。对照组实施常规护理,试验组在常规护理的基础上实施居家多重用药安全管理方案,并借助虚拟现实技术进行干预。开展为期1年的随访干预,比较两组干预前、出院后1、3、6、12个月的居家多重用药安全管理目标行为发生率、服药依从性[Morisky用药依从性问卷(MMAS-8)]和再入院率。结果:出院后1个月试验组病人重复服药、漏服药、自行停药、自行增减药物、改变用药时间的发生率低于对照组(P<0.05);出院后3、6个月两组病人各项指标比较差异均有统计学意义(P<0.05);出院后12个月试验组重复服药、错服药和自行停药的发生率低于对照组(P<0.05)。试验组在不同时间节点的服药依从性评分均高于对照组(P<0.05),试验组1年后的再入院率低于对照组(P<0.05)。结论:老年缺血性脑卒中病人居家多重用药安全管理方案,能够显著改善病人居家多重用药服药行为及依从性,降低1年内再入院率。对保障病人的用药安全具有重要意义,可为居家病人的多重用药安全管理提供理论依据及实践路径。
Objective:To construct a home-based multimedication safety management program for elderly patients with ischemic stroke and verify its effectiveness.Methods:A total of 253 elderly patients with ischemic stroke who were hospitalized in the Department of Geriatrics and the Department of Neurology of a tertiary grade A hospital in Suzhou from June to November 2023 were selected as the research subjects.According to the time of visit,the patients hospitalized from June to August 2023 were divided into the control group(n=128),and those hospitalized from September to November 2023 were divided into the experimental group(n=125).The patients in control group received routine care,while the patients in experimental group implemented a home-based multidrug safety management plan on the basis of routine care and intervened with the aid of virtual reality technology.A one-year follow-up intervention was carried out to compare the incidence of home-based multimedication safety management target behaviors,medication compliance[Morisky Medication Compliance Questionnaire(MMAS-8)],and readmission rates between the two groups before the intervention and at 1,3,6,and 12 months after discharge.Results:One month after discharge,the incidences of repeated medication,missed medication,self-cessation of medication,self-increase or decrease of medication,and change of medication time in the experimental group were lower than those in the control group(P<0.05).There were statistically significant differences in various indicators between the two groups of patients at 3 and 6 months after discharge(P<0.05).Twelve months after discharge,the incidences of repeated medication,incorrect medication and self-withdrawal of medication in the experimental group were lower than those in the control group(P<0.05).The medication compliance scores of the experimental group at different time points were all higher than those of the control group(P<0.05),and the readmission rate of the experimental group one year later was lower than that of the control group(P<0.05).Conclusion:The home-based multimedication safety management program for elderly patients with ischemic stroke can significantly improve the medication behavior and compliance of patients with home-based multimedication,and reduce the readmitted rate within one year.It is of great significance for ensuring the medication safety of patients and can provide theoretical basis and practical paths for the safety management of polypharmacy for patients at home.
作者
田星月
蒋玲
程念开
严红云
于漫驰
孙逸菲
王玥
查慧贤
TIAN Xingyue;JIANG Ling;CHENG Niankai;YAN Hongyun;YU Manchi;SUN Yifei;WANG Yue;ZHA Huixian(The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Jiangsu 215000 China)
出处
《全科护理》
2025年第14期2626-2631,共6页
Chinese General Practice Nursing
基金
苏州市医学重点扶持学科建设-临床护理学,编号:SZFCXK202101
2022年度苏州市立医院护理科研项目,编号:Slyyhl202202。
关键词
老年
缺血性脑卒中
多重用药
安全管理
虚拟现实技术
old age
ischemic stroke
multiple medications
safety management virtual reality technology
