Dang Yen H, Patel-Shori Nima M, Barros Michael, Yu Daohai
University of Maryland Eastern Shore, School of Pharmacy and Health Professions, Department of Pharmacy Practice.
Temple University, School of Pharmacy, Department of Pharmacy Practice.
Innov Pharm. 2020 Jul 31;11(3). doi: 10.24926/iip.v11i3.2406. eCollection 2020.
The purpose of this study is to determine the effectiveness of individualized communication strategies and self-management action plans to improve A1c control at 3 months in patients with low health literacy.
A prospective, open-labeled, pilot study was conducted on 23 patients with diabetes mellitus in a pharmacist-led ambulatory care clinic. Patients who had a Rapid Estimate of Adult Literacy in Medicine- Revised (REALM-R) score of 6 or less and an A1c greater than 7% upon study entry were included. The first group received the teach-back method, personalized actions, and follow-up phone calls to assess comprehension (N = 12). The second group was assigned to usual care (N = 11).
Patients receiving literacy-appropriate interventions had greater A1c percent reduction (A1c difference of -2.0 ± 1.3 vs -1.0 ± 2.2; P = 0.02) and less hyperglycemic events per week (0.1 vs. 2.1; P = 0.04). There were no differences in the number of hypoglycemic events, testing frequency, medication-adherence rates, or hospitalizations and emergency room visits related to diabetes.
Literacy-appropriate methods such as the teach-back method, personalized action plans, and telephone follow-ups may improve glycemic control in low health literate patients with diabetes.
The findings from this study suggest that pharmacists may improve diabetes outcomes when managing patients who possess low health literacy using simplified teaching methods.
本研究旨在确定个性化沟通策略和自我管理行动计划对提高健康素养较低患者3个月时糖化血红蛋白（A1c）控制水平的有效性。
在一家由药剂师主导的门诊护理诊所，对23例糖尿病患者进行了一项前瞻性、开放标签的试点研究。纳入研究时医学成人快速识字评估修订版（REALM-R）得分≤6且A1c大于7%的患者。第一组接受反馈教学法、个性化行动方案以及用于评估理解情况的随访电话（N = 12）。第二组接受常规护理（N = 11）。
接受符合健康素养干预措施的患者糖化血红蛋白百分比降低幅度更大（糖化血红蛋白差异为-2.0±1.3 vs -1.0±2.2；P = 0.02），且每周高血糖事件更少（0.1 vs. 2.1；P = 0.04）。低血糖事件数量、检测频率、药物依从率以及与糖尿病相关的住院和急诊就诊次数方面无差异。
诸如反馈教学法、个性化行动计划和电话随访等符合健康素养的方法，可能改善健康素养较低的糖尿病患者的血糖控制。
本研究结果表明，药剂师在使用简化教学方法管理健康素养较低的患者时，可能改善糖尿病治疗效果。
