| Objective: To investigate the potential risk factors leading to hospitalization of elderly patients with bronchial asthma,to establish and implement a pharmacy service pathway for elderly patients with bronchial asthma using the analysis results as a reference,and to evaluate the role and significance of the pharmacy service model through comparative analysis.Methods: The study was divided into two parts,the first part retrospectively collected case data of adult bronchial asthma patients hospitalized in the respiratory department of a hospital from January 2019 to December 2021,divided the patients into elderly group(≥65 years old)and non-elderly group(18-64 years old)according to their age,compared and analyzed the basic data,clinical related data,laboratory results,medication use and other indicators of the two groups,and screened the elderly bronchial potential risk factors for hospitalization of patients with asthma.In the second part,based on the results of the analyzed risk factors as a reference,a pharmacy service pathway for elderly patients with asthma including pharmacy service targets,pharmacy service process,and pharmacy service content was developed,and pharmacy service and follow-up were carried out.Elderly patients with bronchial asthma who were admitted to the respiratory department of a hospital from January 2022 to December 2022 were selected,and patients from January 2022 to June 2022 were treated as the conventional group,and patients in the conventional group only received daily inpatient medical services;,while patients from July 2022 to December 2022 were treated as the intervention group,and patients in the intervention group received relevant inpatient medical services in addition to In the intervention group,in addition to receiving inpatient medical services,patients in the intervention group were provided with pharmacy services by clinical pharmacists according to the pharmacy service pathway.The effect of pharmacy services was evaluated by comparing and analyzing the economic evaluation,ADR incidence,satisfaction,medication compliance,and asthma control of patients in both groups.Results:The results of the first part of the univariate analysis showed that age of smoking,duration of disease,number of attacks per year,respiratory tract infection,cold air irritation,concomitant pulmonary heart disease,concomitant chronic obstructive pulmonary disease(COPD),comorbidities,and medication compliance were statistically different between the two groups(P<0.05).The results of multifactorial analysis showed that disease duration,respiratory tract infection,cold air irritation,concurrent pulmonary heart disease,concurrent COPD,comorbidity,and medication compliance were independent risk factors for hospitalization of elderly patients with bronchial asthma(OR values were 0.012,0.025,0.041,0.033,0.000,and 0.001,respectively;P values were less than 0.05).The second part of the pharmacy service effect assessment results: the patients in the intervention group had fewer hospitalization days,total hospitalization costs,and drug treatment costs than the conventional group,but there was no statistical difference(P>0.05);the incidence of Adverse Drug Reaction(ADR)was higher in the intervention group than the conventional group during hospitalization,but the incidence of ADR after discharge was lower than the conventional group,and the differences were not statistically significant(P>0.05).The overall satisfaction of patients in the intervention group with the implementation of pharmacy services was higher;the patients in the intervention group were significantly higher than the conventional group in terms of medication compliance and asthma control level one month after discharge(P<0.05);the patients in the intervention group had a significantly higher rate of readmission than the conventional group within two months after discharge(P<0.05),and the rate of readmission was significantly lower than that of the conventional group,but the differences were not statistically significant(P>0.05).There was no statistically significant difference(P>0.05).Conclusion:Potential risk factors for hospitalization in elderly patients with bronchial asthma compared with middle-aged and young patients with bronchial asthma were related to smoking age,duration of disease,number of exacerbations per year,respiratory infections,cold air irritation,medication adherence,comorbidities and complications,providing a reference for early intervention management.2.The implementation of the pharmacy service pathway reduced the costs associated with hospitalization,the incidence of post-discharge ADR,and improved the medication compliance,asthma control and follow-up rate of patients.The implementation of the pharmacy service pathway reduced the costs associated with hospitalization,the incidence of ADR after discharge,and improved patients’ medication compliance,asthma control level and follow-up rate,reflecting the value of clinical pharmacists’ work and providing a basis for further promotion of the standardized pharmacy service model. |
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