药学服务对精神分裂症患者不同临床结局指标影响的Meta分析OA
Meta-Analysis of the Effects of Pharmaceutical Care on Different Clinical Outcomes in Patients with Schizophrenia
目的:对药师参与的药学服务对精神分裂症患者不同临床结局指标的影响进行系统评价.方法:于中英文数据库中系统检索比较常规治疗与药学服务对精神分裂症患者临床结局影响的随机对照试验(RCT),检索时限为建库至 2025 年 10 月 31 日,按照纳入与排除标准筛选文献、提取临床资料,主要结局指标为服药依从性.采用 Cochrane 系统评价手册 RCT 偏倚风险评估工具(RoB 1.0)进行文献质量评价,当纳入研究数量>10 篇时,使用漏斗图分析发表偏倚并采用 Egger 检验进行量化评估,使用R(4.4.3)软件开展逐一敏感性分析,采用 RevMan 5.4 软件进行 Meta 分析.结果:共纳入 11 篇文献,包含研究对象 1 234 例.Meta 分析结果显示,在服药依从性方面,药学服务组患者的服药依从性显著高于对照组(RR=1.22,95%CI=1.09～1.35,P<0.000 01).在安全性和疾病预后方面,药学服务组不良反应发生率较低(RR=0.60,95%CI=0.48～0.76,P<0.000 1),疾病复发率明显降低(RR=0.34,95%CI=0.23～0.51,P<0.000 01),但两组患者简明精神病评定量表评分及再入院率变化无统计学意义(P>0.05).结论:药学服务有助于提高精神分裂症患者的服药依从性,降低不良反应发生率和复发率,但其对 BPRS 评分、再入院率等指标的影响还需要更多的研究来验证.
OBJECTIVE:To conduct a systematic review on the effects of pharmaceutical care provided by pharmacists on different clinical outcomes in patients with schizophrenia.METHODS:Randomized controlled trials(RCT)comparing the effects of conventional treatment and pharmaceutical care on the clinical outcomes of patients with schizophrenia were systematically searched in Chinese and English databases,with the search time limit from database inception to October 31,2025.Literature was screened according to the inclusion and exclusion criteria,and clinical data were extracted.The primary outcome index was medication adherence.The quality of the included studies was evaluated using the Risk of Bias Tool for RCTs(RoB 1.0)of the Cochrane Handbook for Systematic Reviews.When the number of included studies exceeded 10,publication bias was analyzed using funnel plots and quantitatively assessed by Egger's test.A leave-one-out sensitivity analysis was performed using R software(version 4.4.3),and the Meta-analysis was conducted using RevMan 5.4 software.RESULTS:A total of 11 studies were included,involving 1 234 patients.In terms of medication adherence,the medication adherence of patients in the pharmaceutical care group was significantly higher than that in the control group(RR=1.22,95%CI:1.09-1.35,P<0.000 01).Regarding safety and disease prognosis,the incidence of adverse reactions in the pharmaceutical care group was lower(RR=0.60,95%CI:0.48-0.76,P<0.000 1),and the disease recurrence rate was significantly reduced(RR=0.34,95%CI:0.23-0.51,P<0.000 01).However,there were no statistically significant differences in the changes in the brief psychiatric rating scale score and readmission rate between the two groups(P>0.05).CONCLUSIONS:Pharmaceutical care helps improve the medication adherence of patients with schizophrenia and reduce the incidence of adverse reactions and the disease recurrence;however,its effects on indicators such as BPRS score and readmission rate still require more studies for verification.
孙丽萍;徐倩;张嘉桐;姜文龙;孙大伟;彭龙颜;李博慧;刘明超;安宏伟
大庆市第三医院药剂科,黑龙江 大庆 163712||佳木斯大学药学院,黑龙江 佳木斯 154007大庆市第三医院药剂科,黑龙江 大庆 163712大庆市第三医院药剂科,黑龙江 大庆 163712大庆市第三医院精神科,黑龙江 大庆 163712大庆市第三医院精神科,黑龙江 大庆 163712大庆市第三医院精神科,黑龙江 大庆 163712大庆市第三医院精神科,黑龙江 大庆 163712大庆市第三医院精神科,黑龙江 大庆 163712大庆市第三医院精神科,黑龙江 大庆 163712
医药卫生
精神分裂症药学服务Meta分析
SchizophreniaPharmaceutical careMeta-analysis
《中国医院用药评价与分析》 2026 (9)
1087-1091,1098,6
2025年度黑龙江省卫生健康委科研课题(No.20250303090029)
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