Garrett Daniel G, Bluml Benjamin M
American Pharmacists Association Foundation, Washington, D.C. 20037-2985, USA.
J Am Pharm Assoc (2003). 2005 Mar-Apr;45(2):130-7. doi: 10.1331/1544345053623492.
To assess the outcomes for the first year following the initiation of a multisite community pharmacy care services (PCS) program for patients with diabetes.
Quasi-experimental, pre-post cohort study.
80 community pharmacy providers with diabetes certificate program training who were reimbursed for PCS by employers in Greensboro, N.C., Wilson, N.C., Dublin, Ga., Manitowoc County, Wis., and Columbus, Ohio.
256 patients with diabetes covered by self-insured employers' health plans.
Community pharmacist patient care services using scheduled consultations, clinical goal setting, monitoring, and collaborative drug therapy management with physicians and referrals to diabetes educators.
Changes in glycosylated hemoglobin (AIC), low-density lipoprotein cholesterol (LDL-C), blood pressure, influenza vaccinations, foot examinations, eye examinations, patient goals for nutrition, exercise, and weight, patient satisfaction, and changes medical and medication utilization and costs.
Over the initial year of the program, participants' mean A1C decreased from 7.9% at initial visit to 7.1%, mean LDL-C decreased from 113.4 mg/dL to 104.5 mg/dL, and mean systolic blood pressured decreased from 136.2 mm Hg to 131.4 mm Hg. During this time, influenza vaccination rate increased from 52% to 77%, the eye examination rate increased from 46% to 82%, and the foot examination rate increased from 38% to 80%. Patient satisfaction with overall diabetes care improved from 57% of responses in the highest range at baseline to 87% at this level after 6 months, and 95.7% of patients reported being very satisfied or satisfied with the diabetes care provided by their pharmacists. Total mean health care costs per patient were $918 lower than projections for the initial year of enrollment.
Patients who participated in the program had significant improvement in clinical indicators of diabetes management, higher rates of self-management goal setting and achievement, and increased satisfaction with diabetes care, and employers experienced a decline in mean projected total direct medical costs.
评估针对糖尿病患者启动多地点社区药房护理服务（PCS）项目后第一年的效果。
准实验性前后队列研究。
80家接受过糖尿病证书项目培训的社区药房提供者，这些药房由北卡罗来纳州格林斯伯勒、北卡罗来纳州威尔逊、佐治亚州都柏林、威斯康星州马尼托沃克县以及俄亥俄州哥伦布市的雇主报销PCS费用。
256名由自保雇主健康计划承保的糖尿病患者。
社区药剂师通过定期咨询、设定临床目标、监测以及与医生进行协作药物治疗管理并转诊至糖尿病教育工作者来提供患者护理服务。
糖化血红蛋白（AIC）、低密度脂蛋白胆固醇（LDL-C）、血压的变化，流感疫苗接种情况、足部检查、眼部检查、患者营养、运动和体重目标、患者满意度以及医疗和药物使用及费用的变化。
在该项目的初始年份，参与者的平均糖化血红蛋白从初诊时的7.9%降至7.1%，平均低密度脂蛋白胆固醇从113.4毫克/分升降至104.5毫克/分升，平均收缩压从136.2毫米汞柱降至131.4毫米汞柱。在此期间，流感疫苗接种率从52%升至77%，眼部检查率从46%升至82%，足部检查率从38%升至80%。患者对总体糖尿病护理的满意度从基线时最高范围的57%的回复率提高到6个月后的该水平的87%，并且95.7%的患者报告对药剂师提供的糖尿病护理非常满意或满意。每位患者的平均医疗保健总费用比入组初始年份的预测低918美元。
参与该项目的患者在糖尿病管理的临床指标方面有显著改善，自我管理目标设定和达成率更高，对糖尿病护理的满意度增加，并且雇主的预计总直接医疗费用均值有所下降。
