Periodicals Department, American Pharmacists Association, Washington, DC 20037, USA.
J Am Pharm Assoc (2003). 2010 Sep-Oct;50(5):623-6. doi: 10.1331/JAPhA.2010.09112.
To review relevant trends threatening primary care and the evidence supporting use of nonphysicians in primary and chronic care of patients with diabetes.
Current medical and pharmacy literature as selected by authors.
The care needed by patients with diabetes does not fit well into our current medical model for primary care, and an adequate supply of physicians is not likely to be available for primary care roles in coming years. Patients with diabetes who are placed on evidence-based regimens, are educated about their disease, are coached in ways that motivate them to lose weight and adopt other therapeutic lifestyle changes, and are adhering to and persisting with therapy will soon have improved clinical parameters. These quickly translate into fewer hospitalizations and emergency department visits. A growing body of literature supports the use of pharmacists and other nonphysicians in meeting the needs of patients with diabetes. Pharmacists should join nurse practitioners, specially trained nurses, and physician assistants as integral members of the health care team in providing care to patients with diabetes and, by logical extension, other chronic conditions.
Demand for primary care is likely to outstrip the available supply of generalist physicians in the coming years. In addition to nurse practitioners and physician assistants, pharmacists should be considered for key roles in future interdisciplinary teams that triage and provide direct care to patients, including those with diabetes and other chronic conditions.
综述威胁初级保健的相关趋势，以及在糖尿病患者的初级保健和慢性病管理中使用非医师的证据。
作者选择的当前医学和药学文献。
糖尿病患者所需的护理与我们当前的初级保健医学模式不太契合，而且在未来几年，初级保健角色可能都无法获得足够数量的医师。将接受基于证据的治疗方案的糖尿病患者，对其疾病进行教育，以激励他们减轻体重和采取其他治疗性生活方式改变的方式进行辅导，并坚持和坚持治疗，很快就会改善临床参数。这些将迅速转化为减少住院和急诊就诊的次数。越来越多的文献支持使用药剂师和其他非医师来满足糖尿病患者的需求。药剂师应与执业护士、受过专门培训的护士以及医师助理一起，成为向糖尿病患者以及其他慢性病患者提供护理的医疗团队的重要成员。
在未来几年，对初级保健的需求可能会超过普通科医生的现有供应量。除了执业护士和医师助理外，药剂师也应该被考虑在未来的跨学科团队中担任关键角色，对患者进行分诊和直接护理，包括糖尿病患者和其他慢性病患者。
