Jahangard-Rafsanjani Zahra, Sarayani Amir, Nosrati Marzieh, Saadat Navid, Rashidian Arash, Hadjibabaie Molouk, Ashouri Asieh, Radfar Mania, Javadi Mohammadreza, Gholami Kheirollah
Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran (Dr Jahangard-Rafsanjani, Dr Radfar)
Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran (Dr Sarayani, Dr Ashouri)
Diabetes Educ. 2015 Feb;41(1):127-35. doi: 10.1177/0145721714559132. Epub 2014 Nov 24.
The purpose of the study was to investigate the efficacy of a community pharmacist-delivered diabetes support program for patients receiving specialty medical care in a middle-income country (Iran).
A randomized controlled trial was conducted on 101 patients who received diabetes care from an endocrinologist. A qualified community pharmacist educated patients about medications, clinical goals, self-care activities, and self-monitoring of blood glucose. The pharmacist trained patients in the intervention group for 5 months (5 follow-up visits and 5 phone calls) and recommended physician visits when necessary. The primary outcome was A1C, and the secondary outcomes included self-care activities, medication adherence, blood pressure, and body mass index. Satisfaction and willingness to pay was assessed in the intervention group.
Eighty-five patients completed the study, and baseline A1C was similar between groups (intervention: 7.6 ± 1.6 [59 mmol/mol] vs control: 7.5 ± 1.9 [58 mmol/mol]). No significant difference was observed between study groups at the end of the trial period; however, the amount of A1C reduction was higher in the intervention group (1.0% ± 1.5% vs 0.5% ± 1.5%). Self-care activity was improved in general diet, blood glucose monitoring, and foot care subcategories in the intervention group. Medication adherence and body mass index were significantly improved in the intervention group at the end of study.
A community pharmacist intervention improved self-care activity, medication adherence, and body mass index in patients receiving specialty medical care. Baseline A1C values and the presence of specialty medical care should be considered in the interpretation of clinical findings.
本研究旨在调查在中等收入国家(伊朗),由社区药剂师提供的糖尿病支持项目对接受专科医疗护理的患者的疗效。
对101名接受内分泌科医生糖尿病护理的患者进行了一项随机对照试验。一名合格的社区药剂师就药物治疗、临床目标、自我护理活动和血糖自我监测等方面对患者进行教育。药剂师对干预组的患者进行了5个月的培训(5次随访和5次电话沟通),并在必要时建议患者就诊。主要结局指标是糖化血红蛋白(A1C),次要结局指标包括自我护理活动、药物依从性、血压和体重指数。对干预组的满意度和支付意愿进行了评估。
85名患者完成了研究,两组的基线糖化血红蛋白水平相似(干预组:7.6±1.6[59 mmol/mol],对照组:7.5±1.9[58 mmol/mol])。在试验期结束时,研究组之间未观察到显著差异;然而,干预组的糖化血红蛋白降低幅度更高(1.0%±1.5%对0.5%±1.5%)。干预组在总体饮食、血糖监测和足部护理等自我护理活动子类别方面有所改善。在研究结束时,干预组的药物依从性和体重指数有显著改善。
社区药剂师干预改善了接受专科医疗护理患者的自我护理活动、药物依从性和体重指数。在解释临床结果时应考虑基线糖化血红蛋白值和专科医疗护理的存在情况。