Application of closed-loop management in safe drug administration among elderly tuberculosis patients

doi:10.3969/j.issn.1000-6621.2019.11.010

Abstract

Abstract:

Objective To analyze the application effect of using closed-loop management for safe drug administration among elderly tuberculosis patients.Methods Three hundred and two elderly patients with pulmonary tuberculosis treated in Shaanxi Provincial Tuberculosis Hospital from January 1, 2017 to December 30, 2017 were enrolled as control group, for whom situation of medication non-compliance in the course of treatment were investigated. 295 elderly patients with pulmonary tuberculosis treated from January 1, 2018 to December 30, 2018 were enrolled as observation group. Closed-loop management was implemented on the observation group to correct those medication non-compliances found in the control group which included establishing drug safety management protocol and implementing management, evaluating the effect of the implementation, analyzing problems existing during the safe medication management process, and rectifying and tracking problems found. The compliance of taking medicine, the incidence and detection rate of adverse drug reactions were compared between those two groups.Results In observation group, 95.60% (282/295) patients took medicine timely, and the detection rate of adverse drug reactions was 92.11% (105/114), both of them were higher than that in control group (medicine taking correctness 74.83%(226/302), detection rate 76.74% (99/129)).Those differences were statistically significant (χ ²=50.694,10.599, P=0.000, 0.001). The difference of the incidence of adverse drug reactions rate in two group was not statistically significant (observation group 38.64% (114/295), control group 42.72% (129/302), χ ²=1.025,P=0.311).Conclusion Closed-loop management can improve the compliance of medicine taking. It has no effect on the incidence of adverse drug reactions but can improve the detection rate, and increase the safety of medication among elderly patients with pulmonary tuberculosis.

Key words: Tuberculosis, pulmonary, Medication reconciliation, Health services for the aged, Medication therapy management, Data interpretation, statistical

ZHANG Ning,MA Yun,WANG Rong,CUI Bei,LIU Li. Application of closed-loop management in safe drug administration among elderly tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2019, 41(11): 1197-1202. doi: 10.3969/j.issn.1000-6621.2019.11.010

Figures/Tables 2

References 21

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人口学及一般临床特征	观察组(295例)	对照组(302例)	χ²值	P值
性别^a			3.037	0.081
男	173(58.64)	198(65.56)
女	122(41.36)	104(34.44)
年龄组(岁)^a			3.367	0.186
60~	64(21.70)	79(26.16)
70~	146(49.49)	154(50.99)
≥80	85(28.81)	69(22.85)
并发症^b			3.634	0.603
慢性阻塞性肺疾病	22(7.46)	32(10.60)
心功能不全	15(5.08)	17(5.63)
肾功能不全	10(3.39)	13(4.30)
糖尿病	18(6.10)	14(4.64)
高血压	45(15.25)	39(12.91)
支气管扩张	6(2.03)	9(2.98)
文化程度^a			5.595	0.061
初中以下	163(55.25)	194(64.24)
初中和高中	97(32.88)	84(27.81)
高中以上	35(11.87)	24(7.95)
病程(月)^a			2.088	0.352
6	96(32.54)	112(37.09)
7~	159(53.90)	145(48.01)
>12	40(13.56)	45(14.90)
肺结核诊断类型^a			0.779	0.378
初治	252(85.42)	250(82.78)
复治	43(14.58)	52(17.22)
耐药情况^a			0.264	0.607
是	89(30.17)	97(32.12)
否	206(69.83)	205(67.88)

药物不良反应	观察组(295例)	对照组(302例)	χ²值	P值
胃肠道反应	78.07(89/114)	71.32(92/129)	1.452	0.228
肝功能损伤	68.42(78/114)	55.81(72/129)	4.072	0.044
神经系统损伤	57.89(66/114)	41.86(54/129)	6.225	0.013
血液系统异常	47.37(54/114)	37.98(49/129)	2.182	0.140
超敏反应	32.46(37/114)	36.43(47/129)	0.423	0.515
骨关节损伤(关节肿痛)	24.56(28/114)	10.60(32/129)	0.002	0.965
其他	8.77(10/114)	5.63(8/129)	0.583	0.445
合计	38.64(114/295)	42.71(129/302)	1.025	0.311