Article(id=1291404320960934034, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404284806030089, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.04.022, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1723651200000, receivedDateStr=2024-08-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785824383249, onlineDateStr=2026-08-04, pubDate=1740672000000, pubDateStr=2025-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785824383249, onlineIssueDateStr=2026-08-04, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785824383249, creator=13701087609, updateTime=1785824383249, updator=13701087609, issue=Issue{id=1291404284806030089, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='4', pageStart='451', pageEnd='600', issueExtLink='null', onlineDate='null', pubDate='1740672000000', pubDateStr='2025-02-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785824374629, creator='13701087609', updateTime=1785897184019, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1291709669605663367, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404284806030089, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1291709669605663368, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404284806030089, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=556, endPage=560, ext={EN=ArticleExt(id=1291404321174843539, articleId=1291404320960934034, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Study of factors influencing the quality of warfarin anticoagulation in elderly patients with non-valvular atrial fibrillation, columnId=1246531412438966969, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Reader’s Field, runingTitle=null, highlight=null, articleAbstract=
Objective To investigate the factors affecting the quality of warfarin anticoagulation therapy in elderly patients with nonvalvular atrial fibrillation (NVAF) and to assess the effect of the combined physician-pharmacist outpatient model on improving the quality of anticoagulation.
Methods In this study, elderly NVAF patients treated with warfarin were divided into combined physician-pharmacist outpatient group and general outpatient group to assess the impact of different anticoagulation management strategies on patients. On this basis, patients were further classified into good anticoagulation quality group (TTR≥60%) and poor anticoagulation quality group (TTR<60%) based on the percentage of time (TTR) that their international normalised ratio (INR) was within the therapeutic target range, and the clinical prognosis and adverse events that occurred in both groups were analysed.
Results The mean TTR of patients in the combined physician-pharmacist outpatient group was (64.00±24.40)%, which was significantly higher than that of the general outpatient group, which was (42.10±30.20)% (P<0.05). Multifactorial logistic regression analysis showed that the number of comorbidities≥4 was an independent risk factor for poor anticoagulation quality (OR: 0.44, 95%CI: 0.23-0.87, P<0.05), whereas the combined physician-pharmacist outpatient clinic model significantly improved the anticoagulation quality of warfarin (OR: 3.50, 95%CI: 1.85-6.60, P<0.05). Although there were no significant differences between the two groups in the incidence of thromboembolic and bleeding events, the model showed potential advantages in the management of complex patients.
Conclusion The combined physician-pharmacist outpatient model effectively improves the quality of anticoagulation therapy in elderly patients with NVAF by providing personalized anticoagulation treatment plans and medication management services. This model has a particularly positive impact on patients with multiple comorbidities, demonstrating its significant value in clinical practice.
, authors=Rui LI
1, 2a, Mang-mang PAN
2a, Chi ZHANG
2a, Long SHEN
2b, Ling-cong KONG
2b, Tian SHUANG
2b, Xin-hua WANG
2b, Zhi-chun GU
2a, 3, Na WANG
4, Hou-wen LIN
2a, authorsList=Rui LI, Mang-mang PAN, Chi ZHANG, Long SHEN, Ling-cong KONG, Tian SHUANG, Xin-hua WANG, Zhi-chun GU, Na WANG, Hou-wen LIN, authorCompany=null, correspAuthors=Hou-wen LIN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291404321506193556, articleId=1291404320960934034, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=高龄非瓣膜性心房颤动患者华法林抗凝质量的影响因素研究, columnId=1246531414020219657, journalTitle=中国临床药理学杂志, columnName=读者园地, runingTitle=null, highlight=null, articleAbstract=
目的 探讨高龄非瓣膜性心房颤动（NVAF）患者华法林抗凝治疗质量的影响因素，并评估医师-药师联合门诊模式对改善抗凝质量的效果。
方法 本研究将接受华法林治疗的高龄NVAF患者分为医师-药师联合门诊组和普通门诊组，以评估不同抗凝管理策略对患者的影响。在此基础上，进一步将患者依据其国际标准化比值（INR）在治疗目标范围内的时间百分比（TTR）分为良好抗凝质量组（TTR≥60%）和差抗凝质量组（TTR<60%），分析2组患者的临床预后及发生的不良事件。
结果 医师-药师联合门诊组患者的平均TTR为（64.00±24.40）%，显著高于普通门诊组的（42.10±30.20）%（P<0.05）。多因素逻辑回归分析表明，合并症数量≥4种是抗凝质量不佳的独立风险因素（OR：0.44，95%CI：0.23~0.87，P<0.05），而医师-药师联合门诊模式显著提高了华法林的抗凝质量（OR：3.50，95%CI：1.85~6.60，P<0.05）。尽管在血栓栓塞和出血事件的发生率上2组均无显著性差异，但医师-药师联合模式在管理复杂患者方面显示出潜在优势。
结论 医师-药师联合门诊模式通过提供个性化的抗凝治疗方案及药物管理服务，有效改善了高龄NVAF患者的抗凝治疗质量，尤其对于合并症较多的患者具有积极影响，展现了该模式在临床实践中的重要价值。
, authors=李睿
1, 2a, 潘忙忙
2a, 张弛
2a, 沈珑
2b, 孔令璁
2b, 双田
2b, 王新华
2b, 顾智淳
2a, 3, 王娜
4, 林厚文
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李睿（1999-），女，硕士研究生，主要从事循证药学和临床药学方面的研究
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1.上海海洋大学 食品学院，上海 201306
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