Ayadurai Shamala, Hattingh H Laetitia, Tee Lisa B G, Md Said Siti Norlina
Curtin University, School of Pharmacy, Kent Road, Bentley, Perth, WA 6102, Australia.
Ministry of Health, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia.
J Diabetes Res. 2016;2016:5897452. doi: 10.1155/2016/5897452. Epub 2016 May 10.
Background. We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care. Methods. A search on randomised controlled trials (RCT) on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted. Results and Discussion. Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin) reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years; therefore long term outcomes could not be established. Conclusion. Although pharmacists' contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful.
背景。我们对当前2型糖尿病的糖尿病干预研究进行了综述,并确定了药剂师提供优质糖尿病护理的机会。方法。对2010年至2015年间发表的包括药剂师在内的医疗保健专业人员进行糖尿病管理的随机对照试验(RCT)进行了检索。结果与讨论。糖尿病管理包括多因素干预,其中包括糖尿病指南中概述的七个因素,即血糖、胆固醇和血压控制、药物治疗、生活方式、教育以及心血管危险因素。除了三项随机对照试验表明糖化血红蛋白(HbA1c)降低幅度为0.5%至1.8%外,大多数研究没有提供证据表明所采用的干预方法包括了所有七个因素。糖化血红蛋白降低幅度的差异表明缺乏标准化和一致的糖尿病护理方法。此外,大多数研究的持续时间为1个月至2年;因此,无法确定长期结果。结论。尽管药剂师对改善糖尿病患者临床结局的贡献有充分记录,但提供结构化、一致的循证护理的方法并未明确规定。因此,实现长期持续护理的方法尚不确定。包含所有七个循证因素的干预策略将是有用的。