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药物治疗教育对2型糖尿病患者药物依从性和不良结局的影响:一项前瞻性随机研究。

Impact of pharmacotherapeutic education on medication adherence and adverse outcomes in patients with type 2 diabetes mellitus: a prospective, randomized study.

作者信息

Marušić Srećko, Meliš Petra, Lucijanić Marko, Grgurević Ivica, Turčić Petra, Neto Paulo Roque Obreli, Bilić-Ćurčić Ines

机构信息

Srećko Marušić, Medical Department, University Hospital Dubrava, Av. Gojka Šuška 6, 10000 Zagreb, Croatia,

出版信息

Croat Med J. 2018 Dec 31;59(6):290-297. doi: 10.3325/cmj.2018.59.290.

Abstract

AIM

To evaluate the impact of pharmacotherapeutic education on 30-day post-discharge medication adherence and adverse outcomes in patients with type 2 diabetes mellitus (T2DM).

METHODS

The prospective, randomized, single-center study was conducted at the Medical Department of University Hospital Dubrava, Zagreb, between April and June 2018. One hundred and thirty adult patients with T2DM who were discharged to the community were randomly assigned to either the intervention or the control group. Both groups during the hospital stay received the usual diabetes education. The intervention group received additional individual pre-discharge pharmacotherapeutic education about the discharge prescriptions. Medication adherence and occurrence of adverse outcomes (adverse drug reactions, readmission, emergency department visits, and death) were assessed at the follow-up visit, 30 days after discharge.

RESULTS

The number of adherent patients was significantly higher in the intervention group (57/64 [89.9%] vs 41/61 [67.2%]; χ2 test, P=0.003]. There was no significant difference between the groups in the number of patients who experienced adverse outcomes (31/64 [48.4%] vs 36/61 [59.0%]; χ2 test, P=0.236). However, higher frequencies of all adverse outcomes were consistently observed in the control group.

CONCLUSION

Pharmacotherapeutic education of patients with T2DM can significantly improve 30-day post-discharge medication adherence, without a significant reduction in adverse clinical outcomes. ClinicalTrial.gov identification number: NCT03438162.

摘要

目的

评估药物治疗教育对2型糖尿病(T2DM)患者出院后30天药物依从性及不良结局的影响。

方法

本前瞻性、随机、单中心研究于2018年4月至6月在萨格勒布市杜布拉瓦大学医院内科进行。130例成年T2DM患者出院后被随机分为干预组或对照组。两组患者在住院期间均接受常规糖尿病教育。干预组在出院前接受了关于出院处方的额外个体化药物治疗教育。在出院后30天的随访中评估药物依从性及不良结局(药物不良反应、再入院、急诊就诊和死亡)的发生情况。

结果

干预组依从性患者数量显著更高(57/64 [89.9%] 对41/61 [67.2%];χ²检验,P = 0.003)。两组间发生不良结局的患者数量无显著差异(31/64 [48.4%] 对36/61 [59.0%];χ²检验,P = 0.236)。然而,对照组中所有不良结局的发生率均持续较高。

结论

对T2DM患者进行药物治疗教育可显著提高出院后30天的药物依从性,且不会显著降低不良临床结局。ClinicalTrial.gov标识符:NCT03438162。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c6e/6330775/07461d7f8b53/CroatMedJ_0290-F1.jpg

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