Discussion
inappropriate drug, hypertension, chronic disease
EVENTS, HYPERTENSION, ADVERSE DRUG REACTIONS, CHRONIC DISEASE
In this study, MTM was implemented in middle-aged and elderly MMD patients with hypertension to observe the impact of MTM on blood pressure, EQ-5D scale, average daily medication therapy cost, readmission rate, and number of DRPs.We found that diastolic and systolic blood pressure of the intervention group in the sixth and twelfth months after discharge were significantly lower than that at the initial phase of admission (NCDs are the main ailments threatening health and deteriorating the quality of life. Therefore, the pharmaceutical service should also focus on improving the patients’ quality of life [Moreover, MMD patients take multiple drugs simultaneously, with serious economic burdens caused by drug costs. According to statistics, the direct economic cost to older adult patients caused by improper management of polypharmacy is as high as USD 2 billion annually [Studies have shown that patients with polypharmacy are more prone to problems such as improper medication management and adverse drug reactions, which increases hospitalization rates [DRPs refer to events or situations in medication therapy that have interfered or will interfere with the expected therapy results. These problems include adverse drug reactions, medication errors, unclear purpose of drug use, and inappropriate drug selection. The incidence of DRPs gradually increases with the increase in the number of drugs used by patients; 79.8% of older adult patients with polypharmacy have at least one DRP [It has been over ten years since MTM was proposed and has become a mature pharmaceutical care covered by Medicare in the United States. The effect of its implementation has also been tested in practice and confirmed by relevant research, and the effect is very significant in clinical, economic, and humanistic aspects.The new “patient-centered” pharmaceutical care service model—MTM service—enables pharmacists with professional skills to help patients identify and solve problems in medication. Also, clinical pharmacists can be more quickly and better integrated into the clinical treatment team, which reflects the value of pharmacists and contributes to the development of hospital pharmacy in China [The MTM model will be established for MMD in patients with hypertension to help them understand their therapeutic drugs, reduce DRPs, improve patient compliance, reduce their financial burden, and actively convey health consciousness and a healthy lifestyle to patients. Meanwhile, pharmacists will be assisted in improving their pharmaceutical service and MMD management capability, strengthening their communication with patients, improving their service enthusiasm, and reflecting on their professional value.In the future, a drug management model for chronic disease patients should be explored through medical associations, led by clinical pharmacists and participated in by pharmacists in community pharmacies, to obtain better service effects.