社区综合防治合作模式对基层高血压病患者的药物经济学评价

doi:10.3969/j.issn.1000-8535.2018.04.007

广州医药 ›› 2018, Vol. 49 ›› Issue (4): 24-29.DOI: 10.3969/j.issn.1000-8535.2018.04.007

社区综合防治合作模式对基层高血压病患者的药物经济学评价

陈露丝¹, 岳晓军¹, 李韶南², 陈平安², 冯开薇², 吕何锦², 刘震²

1 广州市第十二人民医院内二科(广州 510620);
2 广州市第一人民医院,广州医科大学附属市一人民医院心血管内科(广州 510180)

收稿日期:2018-03-24 出版日期:2018-07-20 发布日期:2021-11-29
通讯作者: 刘震,E-mail:lz71826@163.com
基金资助:
广州市科技计划项目(2012Y2-00025)

Pharmacoeconomic evaluation of community comprehensive prevention on the pharmacotherapy of hypertension in grassroots community

CHEN Lusi¹, YUE Xiaojun¹, LI Shaonan², CHEN Pingan², FENG Kaiwei², LV Hejin², LIU Zhen²

1 Internal Medicine Department II, Guangzhou No. 12 People's Hospital, Guangzhou 510620, China;
2 Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, China

Received:2018-03-24 Online:2018-07-20 Published:2021-11-29

摘要/Abstract

摘要： 目的观察社区综合防治健康管理模式对社区高血压患者血压控制疗效及药物经济学的影响。方法收集2012年7月—2013年7月广州参与研究的三级医院及社区卫生服务中心收治的原发性高血压病患者2 383例,病例入组后随机分为综合管理组和常规治疗组。记录及随访两组高血压患者基线血压值、降压药物使用方案、是否更换药物、血压控制疗效及药物经济学相关费用情况。结果与常规治疗组相比,综合管理组患者血压治疗效果较好,显效率及总有效率提高[(60.71% vs 46.01%); (90.20% vs 71.06%), P＜0.001];高血压治疗及管理的药物费用虽有升高(t=16.186,P＜0.001),但相关的门诊费用、住院费用、护理费用及总费用降低(t=25.647, t=35.785, t=22.274,t=73.710,P＜0.001);在降压方案方面,从减少抗高血压药物使用,减少费用考虑,单独用药方式适合单纯性轻度高血压患者,从费用效果分析上,成本效果比以单药组最低,联用药组逐渐增大;增量成本-效果比:二药联用降压方案优于其他降压联合方案,因而两药联用降压为兼顾疗效和成本的降压较佳组合。结论应用社区综合防治模式对高血压患者进行干预,效果满意,能够有效降低成本-效果比,值得临床推广应用。

关键词: 社区综合防治模式, 高血压, 药物经济学

Abstract: Objective To investigate the effects of comprehensive prevention and control measures on the therapeutic efficient and pharmacoeconomics in community hypertension patients. Methods 2383 cases of hypertension were collected from July 2012 to July 2013 in the tertiary and community hospitals in Guangzhou, which were randomly divided into general therapy group, in which the patients were treated by general administration of drugs, and comprehensive management group that the patients were visited regularly. The sources of drugs, drugs use and changes in drugs were investigated. Results Compared with the general therapy group, better treatment effects were achieved in the comprehensive group. The apparent efficiency and total efficiency were both increased in the comprehensive group[(60.71% vs 46.01%); (90.20% vs 71.06%), P＜0.001]. Although the therapy and pharmacy fees were slightly increased in the comprehensive group as compared to the control group (t=16.186, P＜0.001), the outpatient expenses,hospitalization expenses, nursing expenses and the total expenses were decreased(t=25.647; t=35.785; t=22.274;t=73.710;P＜0.001). Considering reducing the use of drugs and decreasing the cost, the method of using single drug is beneficial to the patients of low-risk mild hypertension. The method of using calcium antagonist is the most economical and reasonable way. Conclusion Standardizing management of hypertension in community is effective in improving hypertension treatment and decreasing the cost, which is thus worth popularizing.

Key words: Comprehensive intervention in community, Hypertension, Pharmacoeconomics

陈露丝, 岳晓军, 李韶南, 陈平安, 冯开薇, 吕何锦, 刘震. 社区综合防治合作模式对基层高血压病患者的药物经济学评价[J]. 广州医药, 2018, 49(4): 24-29.

CHEN Lusi, YUE Xiaojun, LI Shaonan, CHEN Pingan, FENG Kaiwei, LV Hejin, LIU Zhen. Pharmacoeconomic evaluation of community comprehensive prevention on the pharmacotherapy of hypertension in grassroots community[J]. Guangzhou Medical Journal, 2018, 49(4): 24-29.

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社区综合防治合作模式对基层高血压病患者的药物经济学评价

Pharmacoeconomic evaluation of community comprehensive prevention on the pharmacotherapy of hypertension in grassroots community

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