Shoji Masaki, Sakane Naoki, Ito Naoki, Sunayama Keiji, Onda Mitsuko
PhD. Assistant Professor, Osaka Medical and Pharmaceutical University, Japan.
PhD, MD. Division Director, National Hospital Organization, Kyoto Medical Center, Japan.
Pharm Pract (Granada). 2022 Apr-Jun;20(2):2657. doi: 10.18549/PharmPract.2022.2.2657. Epub 2022 Apr 1.
In Japan, there is a pressing need to improve community health care to cope with the rapid aging of the population. In this context, there have been private-sector-led approaches to enhance community dietary support by employing dietitians in pharmacies.
To evaluate the effects of collaboration between dietitians and pharmacists working in pharmacies to support patients with type 2 diabetes.
A single group pre- and post-comparative study was conducted on patients with type 2 diabetes mellitus. The intervention period was 6 months. During the intervention period, the dietitians provided dietary support to the patients after first providing them with medication guidance. The contents of these instructions were shared with the pharmacists. The contents of the instructions were recorded, and confirmed in monthly meetings with the principal investigator. The primary endpoint was the Hemoglobin A1c(HbA1c) level, and the secondary endpoints were high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), Triglyceride (TG), degree of dietary self-management, degree of unbalanced diet and satisfaction with pharmacy services.
Eight patients completed the intervention period. The first patient's intervention started in March 2021, and all patients' interventions were completed by December 2021. The primary endpoint, the mean (SD) HbA1c, was 7.26 (0.96) at baseline and decreased to 6.63 (0.79) after 6 months (p=0.028, r=0.72). Also, the HDL-c increased from 55.00 (14.81) to 63.14 (10.11) (p=0.110, r=0.51) and the Diabetes Mellitus Dietary Self Efficacy Scale score increased from 51.67 (8.31) to 60.17 (8.45) (p=0.025, r=0.79) and the patient satisfaction score increased 24.0 (4.0) to 26.1 (3.3) (p=0.161, r=0.51). Moderate decreases were also observed in LDL-c (p=0.235, r=0.47) and TG (p=0.368, r=0.37).
Collaboration between dietitians and pharmacists working in pharmacies may improve the dietary habits and glycemic control of patients with type 2 diabetes. To verify this hypothesis more reliably, randomized controlled trials need to be conducted.
在日本，迫切需要改善社区医疗保健以应对人口的快速老龄化。在此背景下，出现了由私营部门主导的通过在药店雇佣营养师来加强社区饮食支持的方法。
评估在药店工作的营养师和药剂师合作对2型糖尿病患者的支持效果。
对2型糖尿病患者进行单组前后对照研究。干预期为6个月。在干预期内，营养师在为患者提供用药指导后，为其提供饮食支持。这些指导内容会与药剂师分享。指导内容会被记录下来，并在与主要研究者的月度会议上得到确认。主要终点是糖化血红蛋白（HbA1c）水平，次要终点是高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、甘油三酯（TG）、饮食自我管理程度、饮食不均衡程度以及对药房服务的满意度。
8名患者完成了干预期。第一名患者的干预于2021年3月开始，所有患者的干预均于2021年12月完成。主要终点，即平均（标准差）HbA1c，在基线时为7.26（0.96），6个月后降至6.63（0.79）（p = 0.028，r = 0.72）。此外，HDL-c从55.00（14.81）升至63.14（10.11）（p = 0.110，r = 0.51），糖尿病饮食自我效能量表评分从51.67（8.31）升至60.17（8.45）（p = 0.025，r = 0.79），患者满意度评分从24.0（4.0）升至26.1（3.3）（p = 0.161，r = 0.51）。LDL-c（p = 0.235，r = 0.47）和TG（p = 0.368，r = 0.37）也有适度下降。
在药店工作的营养师和药剂师之间的合作可能会改善2型糖尿病患者的饮食习惯和血糖控制。为了更可靠地验证这一假设，需要进行随机对照试验。
