Taveira Tracey H, Pirraglia Paul A, Cohen Lisa B, Wu Wen-Chih
Providence Veterans Affairs Medical Center, RI, USA.
Prev Cardiol. 2008 Fall;11(4):195-200. doi: 10.1111/j.1751-7141.2008.00008.x.
Coexisting mental health conditions (MHCs) attenuate treatment effects in diabetes. A retrospective analysis was performed of a pharmacist-led cardiovascular risk reduction clinic (CRRC) targeting hypertension, diabetes, hyperlipidemia, and tobacco use in patients with at least one CRRC visit between January 2001 and January 2002. The United Kingdom Prospective Diabetes Study (UKPDS) risk change (after/before CRRC) for those with and without MHCs was compared. Of the 297 with diabetes and complete UKPDS data, 40.7% had at least 1 MHC (22.3% had a severe MHC). Patients with MHCs had a similar number of CRRC visits (4.7+/-2.6 vs 4.4+/-2.6) but had a lower baseline UKPDS score (0.31+/-0.18 vs 0.40+/-0.20; P=.001) compared with non-MHC patients. The risk change after CRRC was similar for those with and without MHCs (0.10+/-0.13 vs 0.10+/-0.14; P=.82), but patients with MHCs had a longer CRRC enrollment (245+/-152 vs 205+/-161 days; P<.03). The efficacy of the CRRC model to reduce cardiovascular risk is not attenuated by a concomitant MHC.
并存的心理健康状况（MHCs）会减弱糖尿病治疗效果。对一家由药剂师主导的心血管风险降低诊所（CRRC）进行了回顾性分析，该诊所针对2001年1月至2002年1月期间至少就诊过一次CRRC的高血压、糖尿病、高脂血症和吸烟患者。比较了有和没有MHCs的患者的英国前瞻性糖尿病研究（UKPDS）风险变化（CRRC后/CRRC前）。在297例有糖尿病且有完整UKPDS数据的患者中，40.7%至少有一种MHC（22.3%有严重MHC）。与无MHC患者相比，有MHC的患者CRRC就诊次数相似（4.7±2.6次对4.4±2.6次），但基线UKPDS评分较低（0.31±0.18对0.40±0.20；P = 0.001）。有和没有MHCs的患者在CRRC后的风险变化相似（0.10±0.13对0.10±0.14；P = 0.82），但有MHC的患者CRRC登记时间更长（245±152天对205±161天；P<0.03）。CRRC模型降低心血管风险的疗效不会因并存的MHC而减弱。
