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社区药房糖尿病与高血压护理项目的成效:巴基斯坦社区药剂师未被发掘的机遇

Effectiveness of Community Pharmacy Diabetes and Hypertension Care Program: An Unexplored Opportunity for Community Pharmacists in Pakistan.

作者信息

Malik Madeeha, Hussain Azhar, Aslam Usman, Hashmi Ayisha, Vaismoradi Mojtaba, Hayat Khezar, Jamshed Shazia

机构信息

Department of Pharmacy Practice, Hamdard Institute of Pharmaceutical Sciences, Hamdard University Islamabad, Islamabad, Pakistan.

Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.

出版信息

Front Pharmacol. 2022 May 17;13:710617. doi: 10.3389/fphar.2022.710617. eCollection 2022.

Abstract

The effective management of patients diagnosed with both Diabetes as well as Hypertension is linked with administration of efficacious pharmacological therapy as well as improvement in adherence through counseling and other strategies. Being a part of primary healthcare team, community pharmacists can effectively provide patient care for chronic disease management. The objective of the study was to evaluate the impact of pharmacist counseling on blood pressure and blood glucose control among patients having both hypertension and diabetes attending community pharmacies in Pakistan. A randomized, controlled, single-blind, pre-post-intervention study design was used. The respondents included patients diagnosed with diabetes mellitus (Type I or II) and hypertension visiting community pharmacies to purchase their regular medicine. A simple random sampling technique using the lottery method was used to select community pharmacies in groups A (intervention, = 4) and group B (control, = 4). The total number of patients was 40 in each group, while estimating a dropout rate of 25%. The patients in the intervention group received special counseling. Blood pressure and blood glucose were checked after every 15 days for 6 months. Prevalidated tools such as the hypertension knowledge level scale, the diabetes knowledge questionnaire 24, and a brief medication questionnaire was used. Data were coded and analyzed using SPSS 21. Wilcoxon test ( < 0.05) was used to compare pre-post intervention knowledge regarding the disease, while the Mann-Whitney test ( < 0.05) was used to find differences in medication adherence among control and intervention groups. A significant improvement in mean knowledge scores of patients with diabetes (16.02 ±2.93 vs. 19.97 ±2.66) and hypertension (15.60 ±3.33 vs. 18.35 ±2.31) in the intervention group receiving counseling for 6 months than control group ( < 0.05) was noted. Furthermore, the fasting blood glucose levels (8.25 ±1.45) and systolic BP (130.10 ±6.89) were significantly controlled after 6 months in the intervention group. The current study results concluded that community pharmacists' counselling has a positive impact on blood glucose and blood pressure management among patients suffering with both diabetes and hypertension.

摘要

对同时患有糖尿病和高血压的患者进行有效管理,与给予有效的药物治疗以及通过咨询和其他策略提高依从性有关。作为基层医疗团队的一员,社区药剂师可以有效地为慢性病管理提供患者护理。本研究的目的是评估药剂师咨询对巴基斯坦社区药房中同时患有高血压和糖尿病的患者的血压和血糖控制的影响。采用了随机、对照、单盲、干预前后研究设计。受访者包括被诊断患有糖尿病(I型或II型)和高血压并前往社区药房购买常规药物的患者。使用抽签法的简单随机抽样技术来选择A组(干预组,=4)和B组(对照组,=4)中的社区药房。每组患者总数为40名,同时估计失访率为25%。干预组的患者接受了特殊咨询。在6个月内,每15天检查一次血压和血糖。使用了预先验证的工具,如高血压知识水平量表、糖尿病知识问卷24和简短用药问卷。数据使用SPSS 21进行编码和分析。采用Wilcoxon检验(<0.05)比较干预前后关于疾病的知识,而采用Mann-Whitney检验(<0.05)来发现对照组和干预组之间用药依从性的差异。与对照组相比,接受6个月咨询的干预组中糖尿病患者(16.02±2.93对19.97±2.66)和高血压患者(15.60±3.33对18.35±2.31)的平均知识得分有显著提高(<0.05)。此外,干预组在6个月后空腹血糖水平(8.25±1.45)和收缩压(130.10±6.89)得到了显著控制。本研究结果得出结论,社区药剂师的咨询对同时患有糖尿病和高血压的患者的血糖和血压管理有积极影响。

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