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一项评估高血压控制不佳的参与者行为变化的药剂师健康辅导试验。

A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension.

机构信息

Discipline of Pharmacy, The School of Health and Biomedical Sciences, RMIT University VIC, Bundoora, VIC, 3083, Australia.

School of Health and Life Sciences, Federation University, University Drive, Mount Helen, Ballarat, Melbourne, Australia.

出版信息

BMC Fam Pract. 2021 Feb 14;22(1):35. doi: 10.1186/s12875-021-01385-0.

Abstract

BACKGROUND

To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension.

METHODS

In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in participants' stages of change with respect to the modifiable health behaviours; diet, exercise, and medication management were assessed. To confirm the behaviour change outcomes, SOC were also assessed in a control group over the same period.

RESULTS

Statistically significant changes in the modifiable health behaviours- medication management (d = 0.19; p = 0.03) and exercise (d = 0.85; p = 0.01) were apparent in participants who received health coaching and were evident through positive changes in the SOC charts. The participants in the control group did not experience significant changes with respect to the SOC. This was parallel to a decrease in mean systolic blood pressure from session one to session four by 7.53 mmHg (p < 0.05, d = - 0.42) in participants who received health coaching. Improvements to medication adherence was also apparent in these participants, evident from the mean scores for the Adherence to Refills and Medications Scale (ARMS), which decreased significantly from a mean of 15.60 to 13.05 (p < 0.05) from session one to four.

CONCLUSIONS

Pharmacist health coaching produced promising health outcomes in participants with poorly controlled hypertension. Pharmacists were able to facilitate a positive behaviour change in participants. However, larger participant cohorts are needed to explore these findings further.

TRIAL REGISTRATION

Australia New Zealand Clinical Trials Registry ACTRN12618001839291 . Date of registration 12/11/2018.

摘要

背景

为了研究药师健康指导是否能促进行为改变阶段(SOC)的进展,以改善血压控制不良的患者的三种可改变的健康行为,即饮食、运动和药物管理。

方法

在这项为期四个月的对照研究中,两名社区药师以每月一次的间隔,为 20 名血压控制不良的患者提供了三次健康指导。评估患者在可改变的健康行为(饮食、运动和药物管理)方面的 SOC 变化。为了确认行为改变的结果,在同一时期也在对照组中评估了 SOC。

结果

在接受健康指导的患者中,药物管理(d=0.19;p=0.03)和运动(d=0.85;p=0.01)的可改变健康行为发生了统计学上的显著变化,并且在 SOC 图表中的积极变化中显而易见。对照组的患者在 SOC 方面没有明显变化。这与接受健康指导的患者的收缩压从第 1 次到第 4 次的平均降低 7.53mmHg 平行(p<0.05,d=-0.42)。这些患者的药物依从性也有所改善,从第 1 次到第 4 次,用药依从性和用药量表(ARMS)的平均评分从 15.60 显著降低至 13.05(p<0.05)。

结论

药师健康指导为血压控制不良的患者带来了有希望的健康结果。药师能够促进患者的积极行为改变。但是,需要更大的患者队列来进一步探讨这些发现。

试验注册

澳大利亚新西兰临床试验注册中心 ACTRN12618001839291。注册日期为 2018 年 11 月 12 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a3f/7883432/a51af2dd97d2/12875_2021_1385_Fig1_HTML.jpg

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