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临床药师参与2型糖尿病患者管理效果观察

Observation on Effect of Management for Type 2 Diabetes Mellitus Patients with Help of Clinical Pharmacists

DOI：

中文关键词: 2型糖尿病血糖临床药师用药指导自我管理合理用药

英文关键词:Type 2 diabetes mellitus Blood glucose Clinical pharmacist Medication guide Self management Rational drug use

基金项目:

作者	单位
龚昌华^① 陆向红^②	①宁波市镇海区人民医院药剂科（浙江宁波 315202）；②浙江大学医学院附属邵逸夫医院下沙院区药剂科。

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中文摘要:

摘要目的：观察临床药师参与2型糖尿病患者管理的效果，为临床治疗提供帮助。方法：187例符合入选标准的2型糖尿病患者随机分成对照组（62例）和试验1组（63例）、试验2组（62例）。对照组接受常规治疗和医师或护士的常规用药教育、饮食控制、运动指导等；试验1组在对照组基础上接受内分泌科临床药师的专业指导，试验2组在试验1组的基础上对至少1名患者家属进行同样的专业指导。出院后临床药师每月对试验1组、试验2组的患者进行电话随访干预。3个月后，比较3组患者各项血糖指标变化情况，统计3组患者低血糖、药品不良反应和再次发病入院例次，通过问卷调查比较3组患者自我管理能力、合理用药认知水平和临床满意度评分。结果：试验1组、试验2组患者的空腹血糖、餐后2h血糖及糖化血红蛋白的改善情况均优于对照组（P＜0.05或P＜0.01）；患者自我管理能力评分也明显优于对照组（P＜0.05或P＜0.01），且试验2组部分指标优于试验1组（P＜0.05）;患者的合理用药认知水平评分更高，不良反应发生人次更低，患者对临床药师的药学指导满意度更高（P＜0.05或P＜0.01）。结论：临床药师参与糖尿病患者的管理，能明显提高患者的认知，提高治疗效果及治疗的依从性，提高患者对临床医疗服务的满意度。

英文摘要:

ABSTRACT Objective:To explore the effect of management for type 2 diabetes mellitus patients with the help of clinical pharmacists, so as to provide help for clinical treatment. Methods:187 type 2 diabetes mellitus patients were randomly divided into control group (62 cases), experimental group 1 (63 cases) and experimental group 2(62 cases). Control group received conventional therapy and the regular medication education, diet control, exercise guidance, etc from doctor or nurse.The experimental group 1 received additional professional education from endocrine clinical pharmacists on the basis of control group. And experimental group 2 received the same professional education but involved at least one family member who received professional education on the basis of experimental group 1. Clinical pharmacists provided telephone follow up for patients in experimental group 1 and group 2 after discharged. After 3 months, Blood glucose parameters changes were compared in three groups, and three groups of patients with hypoglycemia, adverse drug reactions, and again, was hospitalized cases were counted. The self management skills, treatment efficacy, incidence of hypoglycemia and patients’ satisfaction were compared in three groups through questionnaire survey. Results: The improvement of fasting plasma glucose, 2h postprandial glucose and HbA1c in experimental group 1 and experimental group 2 were much better than control group(P＜0.05 or P＜0.01). The patients’ self management skills were also better than the control group(P＜0.05 or P＜0.01).Some parts index of experimental group 2 was superior to group 1. The rationality of drug therapy were superior, incidence of adverse effect was lower, and satisfaction of pharmaceutical guidance was better(P＜0.05 or P＜0.01). Conclusion:The participation of the clinical pharmacists in the management of type 2 diabetes mellitus patients could improve the awareness of health knowledge, treatment efficacy and compliance, increase patients’ satisfaction, and reduce the incidence of hypoglycemia．

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