School of Pharmacy, University of Hertfordshire, Hatfield, UK.
Diabet Med. 2012 Sep;29(9):e326-33. doi: 10.1111/j.1464-5491.2012.03725.x.
To evaluate the impact of a pharmacist-led patient education and diabetes monitoring programme on HbA(1c) and other cardiovascular risk factors in the community setting.
Patients with Type 2 diabetes (n = 46) attending two community pharmacies in Hertfordshire, UK were randomized to one of two groups. Patients in the intervention group (n = 23) received a programme of education about diabetes, its treatment and associated cardiovascular risk factors. These patients were seen for monitoring/counselling by a community pharmacist on six occasions over a 12-month period. Measures included HbA(1c), BMI, blood pressure, blood glucose and lipid profile. Patients in the control group (n = 23) underwent these measurements at baseline and at 12 months only, without specific counselling or education over and above usual care.
HbA(1c) fell from 66 mmol/mol (8.2%) to 49 mmol/mol (6.6%) (P < 0.001) in intervention group, compared with reduction from 65 mmol/mol (8.1%) to 59 mmol/mol (7.5%) in the control group (P = 0.03). Blood pressure fell from 146/87 to 126/81 mmHg in the intervention group (P = 0.01) compared with no significant change in the control group (136/86 to 139/82 mmHg). Significant reductions in BMI (30.8 to 27 kg/m(2), P < 0.001) and blood glucose (8.8 to 6.9 mmol/l, P < 0.001) were also observed in the intervention group as compared with no significant changes in the control group. Lipid profile changes were mixed. In the intervention group, improvements were seen in diabetes-related quality of life (P = 0.001), diabetes knowledge (P = 0.018), belief about the need for medication (P = 0.004) and reduced concerns regarding medication (P < 0.001).
Education and counselling by community pharmacists can result in favourable improvements to the cardiovascular risk profile of patients with Type 2 diabetes.
评估药剂师主导的患者教育和糖尿病监测计划对社区环境中糖化血红蛋白（HbA1c）和其他心血管危险因素的影响。
英国赫特福德郡的两家社区药店就诊的 2 型糖尿病患者（n=46）被随机分为两组。干预组（n=23）的患者接受了关于糖尿病及其治疗和相关心血管危险因素的教育计划。这些患者在 12 个月期间由社区药剂师进行了六次监测/咨询。测量包括 HbA1c、BMI、血压、血糖和血脂谱。对照组（n=23）仅在基线和 12 个月时进行这些测量，而无需进行任何特定的咨询或教育。
干预组的 HbA1c 从 66mmol/mol（8.2%）降至 49mmol/mol（6.6%）（P<0.001），而对照组从 65mmol/mol（8.1%）降至 59mmol/mol（7.5%）（P=0.03）。干预组的血压从 146/87mmHg 降至 126/81mmHg（P=0.01），而对照组无明显变化（136/86mmHg 至 139/82mmHg）。干预组的 BMI（从 30.8kg/m2 降至 27kg/m2，P<0.001）和血糖（从 8.8mmol/L 降至 6.9mmol/L，P<0.001）也有显著降低，而对照组无明显变化。血脂谱的变化是混合的。在干预组中，糖尿病相关生活质量（P=0.001）、糖尿病知识（P=0.018）、对药物治疗需求的信念（P=0.004）和对药物治疗的担忧减少（P<0.001）得到了改善。
社区药剂师的教育和咨询可以使 2 型糖尿病患者的心血管风险状况得到有利改善。
