van Roozendaal Bob W, Krass Ines
Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Faculty of Pharmacy, University of Sydney, Sydney, Australia.
Pharm World Sci. 2009 Oct;31(5):580-595. doi: 10.1007/s11096-009-9312-1. Epub 2009 Jul 23.
To develop an evidence-based checklist to identify potential drug related problems (PDRP) in patients with type 2 diabetes.
The evidence based checklist was applied to records of ambulatory type 2 diabetes patients in New South Wales, Australia.
After comprehensive review of the literature, relevant medication groups and potential drug related problems in type 2 diabetes were identified. All the relevant information was then structured in the form of a checklist. To test the utility of the evidence-based checklist a cross-sectional retrospective study was conducted. The PDRP checklist was applied to the data of 148 patients with established type 2 diabetes and poor glycaemic control. The range and extent of DRPs in this population were identified, which were categorized using the PCNE classification. In addition, the relationship between the total as well as each category of DRPs and several of the patients' clinical parameters was investigated.
Number and category of DRPs per patient.
The PDRP checklist was successfully developed and consisted of six main sections. 682 potential DRPs were identified using the checklist, an average of 4.6 (SD = 1.7) per patient. Metabolic and blood pressure control in the study subjects was generally poor: with a mean HbA1c of 8.7% (SD = 1.5) and mean blood pressure of 139.8 mmHg (SD = 18.1)/81.7 mmHg (SD = 11.1). The majority of DRPs was recorded in the categories 'therapy failure' (n = 264) and 'drug choice problem' (n = 206). Potentially non-adherent patients had a significantly higher HbA1c than patients who adhered to therapy (HbA1c of 9.4% vs. 8.5%; P = 0.01).
This is the first tool developed specifically to detect potential DRPs in patients with type 2 diabetes. It was used to identify DRPs in a sample of type 2 diabetes patients and demonstrated the high prevalence of DRPs per patient. The checklist may assist pharmacists and other health care professionals to systematically identify issues in therapy and management of their type 2 diabetes patients and enable earlier intervention to improve metabolic control.
制定一份循证检查表，以识别2型糖尿病患者潜在的药物相关问题（PDRP）。
该循证检查表应用于澳大利亚新南威尔士州门诊2型糖尿病患者的病历记录。
在全面回顾文献后，确定了2型糖尿病相关的药物类别和潜在药物相关问题。然后将所有相关信息整理成检查表的形式。为了测试循证检查表的实用性，进行了一项横断面回顾性研究。将PDRP检查表应用于148例确诊为2型糖尿病且血糖控制不佳的患者的数据。确定了该人群中药物相关问题的范围和程度，并使用PCNE分类法进行分类。此外，还研究了药物相关问题的总数以及各分类与患者的几个临床参数之间的关系。
每位患者的药物相关问题数量和类别。
成功制定了PDRP检查表，该检查表由六个主要部分组成。使用该检查表共识别出682个潜在的药物相关问题，每位患者平均有4.6个（标准差 = 1.7）。研究对象的代谢和血压控制总体较差：糖化血红蛋白（HbA1c）平均为8.7%（标准差 = 1.5），平均血压为139.8 mmHg（标准差 = 18.1）/81.7 mmHg（标准差 = 11.1）。大多数药物相关问题记录在“治疗失败”（n = 264）和“药物选择问题”（n = 206）类别中。潜在的不依从患者的糖化血红蛋白水平显著高于依从治疗的患者（糖化血红蛋白分别为9.4%和8.5%；P = 0.01）。
这是首个专门为检测2型糖尿病患者潜在药物相关问题而开发的工具。它用于识别2型糖尿病患者样本中的药物相关问题，并显示出每位患者药物相关问题的高发生率。该检查表可协助药剂师和其他医疗保健专业人员系统地识别其2型糖尿病患者治疗和管理中的问题，并实现早期干预以改善代谢控制。
