Batta Razan Adnan, Kasabri Violet, Akour Amal, Hyassat Dana, Albsoul-Younes Abla
University of Jordan, Amman, Jordan.
National center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
Int J Clin Pharm. 2018 Feb;40(1):48-55. doi: 10.1007/s11096-017-0550-3. Epub 2017 Nov 14.
Background and objective Hyperglycemia in pregnancy is a risk factor for cardiovascular disease and postpartum (PP) diabetes. This study aimed to assess the impact of the clinical pharmacist-assisted program (CPAP) of optimizing drug therapy and intensive education on main management outcome measures of patient knowledge about diabetes, Quality of life (QoL) as measured by SF-36 including maternal complications, fasting plasma glucose (FPG) control, and HbA1c. Method This is a randomized controlled study. Pregnant (20-28 weeks) patients with hyperglycemia received CPAP (n = 51) as compared with conventional management (n = 34). Patients were then followed up for 6 weeks pp. Results A significant change was shown in the intervention group for diabetes knowledge (3.47% vs. control 2.03%, P < 0.05) and three aspects of health-related QoL. The need for caesarian delivery (58.8% vs. control 35.3%) and severe episodes of hypoglycemia (0% vs. control 8.8%) were significantly (P < 0.05) reduced in the intervention group. Six weeks PP reduction in HbA1c values was greater in the intervention group (- 0.54% vs. control - 0.08%, P = 0.04) with more FPG-controlled patients during pregnancy (94% vs. control 64.7%). Conclusion Clinical pharmacist assisted services in the management of pregnancy hyperglycemia fundamentally and significantly improve knowledge and disease control.
背景与目的 孕期高血糖是心血管疾病和产后糖尿病的危险因素。本研究旨在评估优化药物治疗和强化教育的临床药师辅助项目(CPAP)对患者糖尿病知识、通过SF-36测量的生活质量(QoL)(包括母体并发症)、空腹血糖(FPG)控制及糖化血红蛋白(HbA1c)等主要管理结局指标的影响。方法 这是一项随机对照研究。将孕期(20 - 28周)高血糖患者分为接受CPAP组(n = 51)和传统管理组(n = 34)。产后对患者进行6周随访。结果 干预组在糖尿病知识(3.47% 对比对照组2.03%,P < 0.05)及健康相关生活质量的三个方面有显著变化。干预组剖宫产需求(58.8% 对比对照组35.3%)和严重低血糖发作(0% 对比对照组8.8%)显著(P < 0.05)降低。产后6周干预组HbA1c值降低幅度更大(-0.54% 对比对照组 -0.08%,P = 0.04),孕期FPG得到控制的患者更多(94% 对比对照组64.7%)。结论 临床药师辅助服务在孕期高血糖管理中从根本上显著改善知识水平及疾病控制情况。