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患者教育对妊娠糖尿病患者知识、态度和行为(KAP)、二甲双胍与胰岛素治疗的药物依从性及治疗效果的影响:印度南部一项基于医院的试点研究

Impact of patient education on KAP, medication adherence and therapeutic outcomes of metformin versus insulin therapy in patients with gestational diabetes: A Hospital based pilot study in South India.

作者信息

Krishnakumar Sneha, Govindarajulu Yeswanth, Vishwanath Usha, Nagasubramanian Vanitha Rani, Palani Thennarasu

机构信息

Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), India.

Sri Ramachandra Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), India.

出版信息

Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1379-1383. doi: 10.1016/j.dsx.2020.07.026. Epub 2020 Jul 18.

DOI:10.1016/j.dsx.2020.07.026
PMID:32755838
Abstract

BACKGROUND AND AIM

The study assessed the impact of continuous patient education on Knowledge, Attitude, Practice (KAP), medication adherence and extent of glycemic control in pregnant women with gestational diabetes on insulin or metformin therapy.

METHODS

81 women with gestational diabetes (37 on insulin and 44 on metformin) were assessed for KAP using a validated questionnaire and medication adherence using the 8-items Morisky medication adherence scale, fasting, and postprandial blood glucose levels at the baseline and after two education sessions on drug therapy at one and three months intervals. The difference in mean KAP, medication adherence scores, fasting, and postprandial blood glucose levels and the extent of glycemic control with insulin or metformin therapy were assessed statistically.

RESULTS

There was a highly significant difference in the mean KAP, medication adherence scores, fasting and postprandial blood glucose levels from baseline to follow-up after three months, (P < 0.0001) indicating that continuous patient education had a positive impact on their KAP, medication adherence, blood glucose levels.

CONCLUSION

The study identified that continuous patient education improved their knowledge and practice of medication adherence which reflected on lowered fasting and postprandial blood glucose levels. Glycemic control was found to be the same with metformin and insulin in gestational diabetes.

摘要

背景与目的

本研究评估了持续的患者教育对接受胰岛素或二甲双胍治疗的妊娠期糖尿病孕妇的知识、态度、行为(KAP)、药物依从性及血糖控制程度的影响。

方法

采用经过验证的问卷对81例妊娠期糖尿病妇女(37例使用胰岛素,44例使用二甲双胍)进行KAP评估,并使用8项Morisky药物依从性量表评估药物依从性,在基线时以及每隔1个月和3个月进行两次药物治疗教育课程后,测量空腹和餐后血糖水平。对平均KAP、药物依从性得分、空腹和餐后血糖水平以及胰岛素或二甲双胍治疗的血糖控制程度的差异进行统计学评估。

结果

3个月后,从基线到随访,平均KAP、药物依从性得分、空腹和餐后血糖水平存在高度显著差异(P < 0.0001),表明持续的患者教育对她们的KAP、药物依从性和血糖水平有积极影响。

结论

该研究表明,持续的患者教育提高了她们对药物依从性的认识和行为,这反映在空腹和餐后血糖水平的降低上。研究发现,在妊娠期糖尿病中,二甲双胍和胰岛素的血糖控制效果相同。

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