Abdelaziz Tarek Samy, Sadek Khaled Marzouk
Department of Internal Medicine -Kasr Alainy Hospital-Cairo University Hospitals, Egypt.
Rom J Intern Med. 2019 Mar 1;57(1):23-29. doi: 10.2478/rjim-2018-0029.
Medication Regimen complexity is an important issue of patients care that needs to be addressed. The aim of this study is the safe reduction of regimens complexities. The effect of this intervention on glycemic control was assessed in this study.
Seventy eight patients were recruited to the study. The entry criteria were non optimal glycemic, non-adherence (as demonstrated by indirect tools), and polypharmacy. The only intervention was the safe reduction of medication regimen complexity. This was done in view of the best practice guidelines; to ensure that all comorbidities are treated with the optimum number of medications for the optimum duration. There was no change to hypoglycemic regimen. All patients, whose hypoglycemic regimen has changed after the recruitment, were excluded. The primary outcome measure was the change in HbA1c three months after the intervention.
Reducing medications regimen complexities led to a significant improvement of HbA1c in the after phase compared to the before phase (mean HbA1c in the before phase was 7.7 ± 0.43% compared to 6.93 ± 0.4% in the after phase. Mean reduction in the HbA1c was 0.77 ± 0.23%, p values < 0.001).
Medications regimen complexity constitutes a burden for patients with diabetes. Reducing such regimens might improve glycemic control in those patients. Further studies are needed to confirm this favourable effect on the glycemic control.
药物治疗方案的复杂性是患者护理中一个需要解决的重要问题。本研究的目的是安全降低治疗方案的复杂性。本研究评估了这种干预措施对血糖控制的影响。
78名患者被纳入该研究。入选标准为血糖控制不佳、不依从(通过间接工具证明)和多种药物治疗。唯一的干预措施是安全降低药物治疗方案的复杂性。这是根据最佳实践指南进行的,以确保所有合并症都用最佳数量的药物进行最佳疗程的治疗。降糖方案没有改变。所有在招募后降糖方案发生变化的患者均被排除。主要结局指标是干预三个月后糖化血红蛋白(HbA1c)的变化。
与干预前相比,降低药物治疗方案的复杂性导致干预后阶段HbA1c有显著改善(干预前阶段平均HbA1c为7.7±0.43%,干预后阶段为6.93±0.4%。HbA1c的平均降低幅度为0.77±0.23%,p值<0.001)。
药物治疗方案的复杂性给糖尿病患者带来负担。减少此类方案可能会改善这些患者的血糖控制。需要进一步研究来证实这种对血糖控制的有利影响。