糖尿病专科诊所的管理方法和治疗结果是否存在差异？对尼日利亚两家教学医院的门诊2型糖尿病患者进行的横断面评估。

Do diabetes-specialty clinics differ in management approach and outcome? A cross-sectional assessment of ambulatory type 2 diabetes patients in two teaching hospitals in Nigeria.

作者信息

Adisa Rasaq, Fakeye Titilayo O

机构信息

Department of Clinical Pharmacy & Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria.

出版信息

Ghana Med J. 2016 Jun;50(2):90-102. doi: 10.4314/gmj.v50i2.7.

DOI:10.4314/gmj.v50i2.7

PMID:27635097

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5012141/

Abstract

OBJECTIVES

To evaluate management approach and outcome in two endocrinologist-managed clinics using data on treatment adherence, diabetes-specific parameters, prescribed medications and self-management practices among ambulatory type 2 diabetes patients. Opinion on cause(s) and perceived fear about diabetes were also explored.

DESIGN

A cross-sectional prospective study using semi-structured interview among consented patients for eightweek, and a review of participants' case notes at 3-month post-interactive contact for details of diabetes-specific parameters and antidiabetes medications.

SETTINGS

The University College Hospital (UCH) and Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in southwestern Nigeria.

PARTICIPANTS

Adult patients with type 2 diabetes, on therapies for >3-month and who had average fasting blood glucose (FBG)>6.0mmol/L were enrolled. All patients with type 1 diabetes, and type 2 diabetes who decline participation were excluded. Out of 185 participants who were approached, 176(95.1%) consented and completed the study including 113(64.2%) from UCH and 63(35.8%) in OAUTHC.

RESULTS

Mean FBG for patients were 9.6mmol/L in UCH and 11.0mmol/L in OAUTHC (p=0.03). Medication adherence among patients was 47(46.5%) in UCH and 31(52.5%) in OAUTHC (p=0.46). Prescribed antidiabetes medications between the clinics significantly differ. Practice of self-monitoring of blood glucose among participants was 26(23.0%) in UCH and 13(20.6%) in OAUTHC (p=0.72). Thirty-two participants (29.4%) in UCH and 33(43.4%) from OAUTHC (p=0.02) mentioned complications as perceived fear about type 2 diabetes.

CONCLUSION

There are differences and similarities between the diabetes-specialty clinics with respect to diabetes management and outcome. This underscores the necessity for a protocol-driven treatment approach in ensuring improved diabetes care and outcome.

FUNDING

None declared.

摘要

目的

利用门诊2型糖尿病患者的治疗依从性、糖尿病特异性参数、处方药物和自我管理实践数据，评估两家由内分泌科医生管理的诊所的管理方法和治疗效果。同时探讨糖尿病病因及患者的恐惧看法。

设计

一项横断面前瞻性研究，对同意参与的患者进行为期八周的半结构化访谈，并在互动接触后3个月查阅参与者的病历，以获取糖尿病特异性参数和抗糖尿病药物的详细信息。

地点

尼日利亚西南部的大学学院医院（UCH）和奥巴费米·阿沃洛沃大学教学医院综合院区（OAUTHC）。

参与者

入选2型糖尿病成年患者，接受治疗超过3个月，平均空腹血糖（FBG）>6.0mmol/L。排除所有1型糖尿病患者以及拒绝参与的2型糖尿病患者。在185名被邀请的参与者中，176名（95.1%）同意并完成了研究，其中UCH的有113名（64.2%），OAUTHC的有63名（35.8%）。

结果

UCH患者的平均空腹血糖为9.6mmol/L，OAUTHC患者为11.0mmol/L（p=0.03）。UCH患者的用药依从性为47名（46.5%），OAUTHC患者为31名（52.5%）（p=0.46）。两家诊所的处方抗糖尿病药物有显著差异。参与者中自我血糖监测的比例UCH为仅26名（23.0%），OAUTHC为13名（20.6%）（p=0.72）。UCH的32名参与者（29.4%）和OAUTHC的33名参与者（43.4%）（p=0.02）提到并发症是对2型糖尿病的恐惧看法。