Pharmacy Department, Pharmacy Practice Research Group, Federal University of Parana, Curitiba, Brazil.
Int J Clin Pharm. 2011 Apr;33(2):273-80. doi: 10.1007/s11096-011-9493-2. Epub 2011 Mar 12.
To evaluate the effects of pharmacotherapy follow-up (PF) on metabolic control and clinical outcomes in type 2 diabetic patients.
Six community pharmacies (4 intervention and 2 control) in the Curitiba metropolitan region (Brazil).
Glycosylated Haemoglobin A1 (HbA1) and fasting capillary glycaemia.
We conducted a 12-month controlled trial involving a total of 161 patients in six community pharmacies between July 2004 and March 2006. Pharmacotherapy follow-up was applied only to patients in the intervention group.
Of the 161 patients enrolled, 96 completed the study (50 intervention and 46 control). The administration of 574 consultations with the intervention group patients led to 119 negative clinical outcomes (2.3/patient [SD = 1.6]). The majority of detected problems were related to the ineffectiveness of pharmacotherapy (68.1%). Relative to the control group, the intervention group exhibited greater glycosylated haemoglobin (HbA1) reduction (-2.2% [95%CI -2.8%:-1.6%] vs. -0.3 [95% CI -0.8:0.2]; P < 0.001) and greater fasting capillary glycaemia reduction (-20.1 mg/dl [95% CI -31.9 mg/dl:-8.3 mg/dl] vs. 4.3 mg/dl [95% CI -13.4 mg/dl:22.2 mg/dl]; P = 0.022). These differences persisted after adjustment for baseline values. There were no significant differences in any other clinical measures between the groups. There were also no significant changes in the number of medications and treatment regimens between groups, with the exception of the percentage of patients undergoing lipid lowering treatment, which increased in the intervention group from 16% to 24% (P = 0.018). The initial medication regimen complexity index (MRCI) in the intervention group was 15.5 (SD = 7.8, range 4-40.5), and it decreased by 1.2 units (SD = 5.9) after 12 months (P = 0.149).
PF of type 2 diabetic patients in community pharmacies can improve the glycaemia control of patients through optimisation of medication profiles without significant changes in either the number of drugs used or the regimen complexity.
评估药物治疗随访（PF）对 2 型糖尿病患者代谢控制和临床结局的影响。
库里蒂巴大都市区的 6 家社区药房（4 家干预组和 2 家对照组）。
糖化血红蛋白（HbA1）和空腹毛细血管血糖。
我们进行了一项为期 12 个月的对照试验，共纳入 2004 年 7 月至 2006 年 3 月期间 6 家社区药房的 161 例患者。仅对干预组患者进行药物治疗随访。
161 例患者中，96 例完成了研究（干预组 50 例，对照组 46 例）。对干预组患者进行了 574 次咨询，共发现 119 例负面临床结局（2.3/患者[SD=1.6]）。大多数发现的问题与药物治疗无效有关（68.1%）。与对照组相比，干预组的糖化血红蛋白（HbA1）降低更明显（-2.2%[95%CI-2.8%:-1.6%] vs.-0.3[95%CI-0.8:0.2]；P<0.001），空腹毛细血管血糖降低更明显（-20.1mg/dl[95%CI-31.9mg/dl:-8.3mg/dl] vs.4.3mg/dl[95%CI-13.4mg/dl:22.2mg/dl]；P=0.022）。调整基线值后，两组间仍存在差异。两组间其他临床指标无显著差异。除降脂治疗患者的比例增加外（干预组从 16%增至 24%，P=0.018），两组间药物治疗方案和治疗方案的数量也无显著变化。干预组的初始药物治疗方案复杂指数（MRCI）为 15.5（SD=7.8，范围 4-40.5），12 个月后降低 1.2 个单位（SD=5.9）（P=0.149）。
社区药房中 2 型糖尿病患者的 PF 可通过优化药物治疗方案改善患者的血糖控制，而不改变用药数量或治疗方案的复杂性。
