挪威社区药房中用于识别未确诊2型糖尿病患者的风险评估和糖化血红蛋白测量——一项可行性研究
Risk assessment and HbA1c measurement in Norwegian community pharmacies to identify people with undiagnosed type 2 diabetes - A feasibility study.
作者信息
Risøy Aslaug Johanne, Kjome Reidun Lisbet Skeide, Sandberg Sverre, Sølvik Una Ørvim
机构信息
Department of Global Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
Centre for pharmacy, Faculty of Medicine, University of Bergen, Bergen, Norway.
出版信息
PLoS One. 2018 Feb 23;13(2):e0191316. doi: 10.1371/journal.pone.0191316. eCollection 2018.
OBJECTIVES
Determine the feasibility of using a diabetes risk assessment tool followed by HbA1c-measurement in a community-pharmacy setting in Norway.
METHODS
In this longitudinal study two pharmacists in each of three community pharmacies were trained to perform risk assessments, HbA1c-measurements and counselling. Pharmacy customers who were > 18 years old and could understand and speak Norwegian or English were recruited in the pharmacies during a two-months-period. Information about the service was presented in local newspapers, social media, leaflets and posters at the pharmacy. Customers wishing to participate contacted the pharmacy staff. Participants completed a validated diabetes risk test and a background questionnaire including a validated instrument for self-rated health. A HbA1c measurement was performed for individuals with a moderate to high risk of developing diabetes. If HbA1c ≥ 6.5% they were recommended to visit their general practitioner for follow-up. The pharmacies performed internal and external quality control of the HbA1c instrument.
RESULTS
Of the 211 included participants 97 (46%) were > 50 years old. HbA1c was measured for the 47 participants (22%) with high risk. Thirty-two (15%) had HbA1c values < 5.7%, twelve (5.4%) had values between 5.7%-6.4%, and three (1.4%) had an HbA1c ≥ 6.5%. Two participants with HbA1 ≥ 6.5% were diagnosed with diabetes by their general practitioner. The third was lost to follow-up. Results from internal and external quality control for HbA1c were within set limits.
CONCLUSION
The pharmacists were able to perform the risk assessment and measurement of HbA1c, and pharmacy customers were willing to participate. The HbA1c measurements fulfilled the requirements for analytical quality. Thus, it is feasible to implement this service in community pharmacies in Norway. In a large-scale study the inclusion criteria should be increased to 45 years in accordance with the population the risk test has been validated for.
目的
确定在挪威社区药房环境中使用糖尿病风险评估工具并随后进行糖化血红蛋白（HbA1c）测量的可行性。
方法
在这项纵向研究中，对三家社区药房中的每家的两名药剂师进行培训，使其能够进行风险评估、HbA1c测量和咨询。在两个月的时间里，在药房招募年龄大于18岁且能理解并说挪威语或英语的药房顾客。有关该服务的信息在当地报纸、社交媒体、传单以及药房的海报上展示。希望参与的顾客联系药房工作人员。参与者完成一份经过验证的糖尿病风险测试以及一份背景问卷，其中包括一份经过验证的自评健康工具。对有中度至高度糖尿病发病风险的个体进行HbA1c测量。如果HbA1c≥6.5%，则建议他们去看全科医生进行随访。药房对HbA1c仪器进行内部和外部质量控制。
结果
在211名纳入的参与者中，97名（46%）年龄大于50岁。对47名（22%）高风险参与者进行了HbA1c测量。32名（15%）的HbA1c值<5.7%，12名（5.4%）的值在5.7% - 6.4%之间，3名（1.4%）的HbA1c≥6.5%。两名HbA1≥6.5%的参与者被其全科医生诊断为糖尿病。第三名失访。HbA1c的内部和外部质量控制结果在设定范围内。
结论
药剂师能够进行风险评估和HbA1c测量，药房顾客愿意参与。HbA1c测量符合分析质量要求。因此，在挪威社区药房实施这项服务是可行的。在大规模研究中，应根据该风险测试已验证的人群将纳入标准提高到45岁。
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