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一项随机对照研究,旨在评估药剂师主导的教育干预对2型糖尿病患者血糖控制、自我护理活动及疾病知识的影响:一项符合CONSORT标准的研究方案。

A randomized controlled study to evaluate the effect of pharmacist-led educational intervention on glycemic control, self-care activities and disease knowledge among type 2 diabetes patients: A consort compliant study protocol.

作者信息

Bukhsh Allah, Nawaz Muhammad Sarfraz, Ahmed Hafiz Sajjad, Khan Tahir Mehmood

机构信息

School of Pharmacy, Monash University, Jalan Lagoon, Selatan, Selangor, Malaysia.

Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore.

出版信息

Medicine (Baltimore). 2018 Mar;97(12):e9847. doi: 10.1097/MD.0000000000009847.

Abstract

BACKGROUND

Diabetes self-care activities, like, healthy diet, regular exercise, self-monitoring of blood glucose, and rational use of medicines are considered to play a vital role in establishing euglycemia. Health literacy among type 2 diabetes mellitus (T2DM) patients in Pakistan is very low, which is the most likely cause for poor clinical outcomes. This study is designed to investigate the impact of pharmacist-led educational intervention on glycemic control, self-care activities and disease knowledge among T2DM patients in Pakistan.

METHODS

In this randomized controlled trail, effectiveness of a 6-month pharmacist-led educational intervention will be examined on glycemic control, diabetes self-care activities and disease knowledge of 80 adult T2DM patients (age >30 years) with poorly controlled T2DM (HbA1c> 7%), after randomizing them into intervention and control groups, at diabetes care clinic of Capital Hospital Islamabad, Pakistan.

RESULTS

The primary outcome is change in patients' HbA1c, whereas, changes in self-care activities and patients' disease knowledge are the secondary outcomes. After baseline assessment of their self-care activities and disease knowledge by using validated Urdu versions of Diabetes Self-management Questionnaire (DSMQ) and Diabetes Knowledge Questionnaire (DKQ), respectively, interventional group patients will be supplemented with a face-to-face pharmacist-led educational intervention, whereas, the control group will receive usual care. Intervention arm patients will be educated successively at their first follow-up visit (12th week) and telephonically after every 4 weeks. All assessments will be made at baseline and end of trail for both intervention and control groups. Multivariate general linear model will be applied to analyze the effects of the intervention.

CONCLUSION

Glycemic control in T2DM patients requires optimum self-care activities. This study is an attempt to improve self-care behaviors among poorly controlled T2DM patients who are at higher risk of diabetes-associated late complications.

摘要

背景

糖尿病自我管理活动,如健康饮食、定期锻炼、血糖自我监测以及合理用药,被认为在实现血糖正常化方面起着至关重要的作用。巴基斯坦2型糖尿病(T2DM)患者的健康素养非常低,这很可能是导致临床预后不佳的原因。本研究旨在调查药剂师主导的教育干预对巴基斯坦T2DM患者血糖控制、自我管理活动及疾病知识的影响。

方法

在这项随机对照试验中,将80名年龄大于30岁、T2DM控制不佳(糖化血红蛋白>7%)的成年患者随机分为干预组和对照组,在巴基斯坦伊斯兰堡首都医院糖尿病护理诊所,检验为期6个月的药剂师主导的教育干预对患者血糖控制、糖尿病自我管理活动及疾病知识的效果。

结果

主要结局是患者糖化血红蛋白的变化,而自我管理活动和患者疾病知识的变化为次要结局。分别使用经过验证的乌尔都语版糖尿病自我管理问卷(DSMQ)和糖尿病知识问卷(DKQ)对患者的自我管理活动和疾病知识进行基线评估后,干预组患者将接受药剂师主导的面对面教育干预,而对照组将接受常规护理。干预组患者将在首次随访(第12周)时接受连续教育,并每4周通过电话进行一次教育。对干预组和对照组均在基线和试验结束时进行所有评估。将应用多变量一般线性模型分析干预效果。

结论

T2DM患者的血糖控制需要最佳的自我管理活动。本研究旨在改善控制不佳、发生糖尿病相关晚期并发症风险较高的T2DM患者的自我管理行为。

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