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药学服务对2型糖尿病患者健康结局的影响。

Influence of pharmaceutical care on health outcomes in patients with Type 2 diabetes mellitus.

作者信息

Al Mazroui Nadia Rashid, Kamal Mostafa Mohamed, Ghabash Naserdeen Mehana, Yacout Targ Ahmed, Kole Prashant Laxman, McElnay James C

机构信息

Department of Pharmacy, Sheikh Zayed Military Hospital, Abu Dhabi, UAE.

出版信息

Br J Clin Pharmacol. 2009 May;67(5):547-57. doi: 10.1111/j.1365-2125.2009.03391.x. Epub 2009 Feb 11.

Abstract

AIMS

To examine the influence of a pharmaceutical care programme on disease control and health-related quality of life in Type 2 diabetes patients in the United Arab Emirates.

METHODS

A total of 240 Type 2 diabetes patients were recruited into a randomized, controlled, prospective clinical trial with a 12-month follow-up. A range of clinical measures, medication adherence and health-related quality of life (Short Form 36) were evaluated at baseline and up to 12 months. Intervention group patients received pharmaceutical care from a clinical pharmacist, whereas control group patients received their usual care from medical and nursing staff. The primary outcome measure was change in HbA(1c). British National Formulary and Framingham scoring methods were used to estimate changes in 10-year coronary heart disease risk scores in all patients.

RESULTS

A total of 234 patients completed the study. Significant reductions (P < 0.001) in mean values (baseline vs. 12 months; 95% confidence interval) of HbA(1c)[8.5% (8.3, 8.7) vs. 6.9% (6.7, 7.1)], systolic [131.4 mmHg (128.1, 134.7) vs. 127.2 mmHg (124.4, 130.1)] and diastolic blood pressure [85.2 mmHg (83.5, 86.8) vs. 76.3 mmHg (74.9, 77.7)] were observed in the intervention group; no significant changes were noted in the control group. The mean Framingham risk prediction score in the intervention group was 10.56% (9.7, 11.4) at baseline; this decreased to 7.7% (6.9, 8.5) (P < 0.001) at 12 months but remained unchanged in the control group.

CONCLUSIONS

The pharmaceutical care programme resulted in better glycaemic control and reduced cardiovascular risk scores in Type 2 diabetes patients over a 12-month period.

摘要

目的

研究药学服务项目对阿联酋2型糖尿病患者疾病控制及健康相关生活质量的影响。

方法

共招募240例2型糖尿病患者,进行一项为期12个月随访的随机对照前瞻性临床试验。在基线及12个月内评估一系列临床指标、药物依从性及健康相关生活质量(简短健康调查问卷36项)。干预组患者接受临床药师的药学服务,而对照组患者接受医护人员的常规治疗。主要结局指标为糖化血红蛋白(HbA1c)的变化。采用英国国家处方集和弗雷明汉评分方法评估所有患者10年冠心病风险评分的变化。

结果

共234例患者完成研究。干预组患者糖化血红蛋白的平均值(基线值与12个月后;95%置信区间)显著降低(P<0.001)[8.5%(8.3,8.7)vs. 6.9%(6.7,7.1)],收缩压[131.4 mmHg(128.1,134.7)vs. 127.2 mmHg(124.4,130.1)]及舒张压[85.2 mmHg(83.5,86.8)vs. 76.3 mmHg(74.9,77.7)]也显著降低;对照组未见显著变化。干预组患者的弗雷明汉风险预测评分在基线时为10.56%(9.7,11.4);12个月时降至7.7%(6.9,8.5)(P<0.001),而对照组保持不变。

结论

药学服务项目在12个月内使2型糖尿病患者的血糖控制更佳,并降低了心血管风险评分。

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