社区药剂师干预以优化糖尿病护理中的他汀类药物依从性：GUIDE-S 研究。
Community pharmacist intervention to optimize statin adherence in diabetes care: The GuIDE-S study.
出版信息
J Am Pharm Assoc (2003). 2023 May-Jun;63(3):946-951. doi: 10.1016/j.japh.2023.03.002. Epub 2023 Mar 16.
BACKGROUND
Statin use in people with type 2 diabetes (T2D) reduces cardiovascular events, yet adherence remains suboptimal.
OBJECTIVE
This study evaluated the impact of a community pharmacist intervention on statin adherence in new users with T2D.
METHODS
As part of a quasi-experimental study, community pharmacy staff proactively identified adult patients with T2D who were not prescribed a statin. When appropriate, the pharmacist prescribed a statin via a collaborative practice agreement or facilitated acquisition of a prescription from another prescriber. Patients received individualized education and follow-up and monitoring for 1 year. Adherence was defined as the proportion of days covered (PDC) by a statin over 12 months. Linear and logistic regression were used to compare the effect of the intervention on continuous and a binary adherence threshold, defined as PDC ≥ 80%, respectively.
RESULTS
Overall, 185 patients started statin therapy and were matched to 370 control patients for analysis. Adjusted average PDC was 3.1% higher in the intervention group (95% CI -0.037 to 0.098). Patients in the intervention group were 21.2% more likely to have PDC ≥ 80% (95% CI 0.828-1.774).
CONCLUSION
The intervention resulted in higher statin adherence than usual care; however, the differences were not statistically significant.
背景
在 2 型糖尿病（T2D）患者中使用他汀类药物可降低心血管事件，但依从性仍不理想。
目的
本研究评估了社区药剂师干预对新使用 T2D 的他汀类药物依从性的影响。
方法
作为一项准实验研究的一部分，社区药房工作人员主动识别未开处方他汀类药物的 T2D 成年患者。在适当的情况下，药剂师通过合作实践协议开处方，或协助从其他处方医生处获得处方。患者接受个体化教育和随访以及 1 年的监测。依从性定义为他汀类药物在 12 个月内的覆盖天数（PDC）的比例。线性和逻辑回归用于比较干预对连续和二进制依从性阈值的影响，分别定义为 PDC≥80%。
结果
共有 185 名患者开始使用他汀类药物治疗，并与 370 名对照患者进行了匹配分析。干预组的平均 PDC 调整后高出 3.1%（95%CI -0.037 至 0.098）。干预组的患者 PDC≥80%的可能性高 21.2%（95%CI 0.828-1.774）。
结论
干预措施比常规护理导致更高的他汀类药物依从性，但差异无统计学意义。
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