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低收入和中等收入国家基于社区药房的糖尿病护理计划的制定、可行性、影响及可接受性

Development, Feasibility, Impact and Acceptability of a Community Pharmacy-Based Diabetes Care Plan in a Low-Middle-Income Country.

作者信息

Ikolaba Fatima S Abdulhakeem, Schafheutle Ellen I, Steinke Douglas

机构信息

Division of Pharmacy and Optometry, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK.

出版信息

Pharmacy (Basel). 2023 Jun 26;11(4):109. doi: 10.3390/pharmacy11040109.

Abstract

Informed by existing research, mostly from high-income countries, this study aimed to develop and test the feasibility of a community pharmacy person-centred goal-setting intervention for people living with type 2 diabetes in a low-middle-income country-Nigeria. The Medical Research Council (MRC) guidance for developing complex interventions framed the intervention development. Patients participated in monthly community pharmacist consultations over six months. Self-reported and clinical outcome measures were collected at baseline and study completion and analysed in STATA V.14. Twenty pharmacists in 20 pharmacies completed the research and enrolled 104 patients. Of these, 89 patients had complete study data, and 70 patients also completed a post-study evaluation questionnaire. In addition, 15 patients and 10 pharmacists were interviewed. All outcome measures showed statistically significant improvements ( < 0.05). Clinical outcomes (BMI, waist circumference, and fasting plasma glucose) improved significantly. Mean patient activation measure (PAM©), quality of life (EQ-VAS©), and medication adherence improved from baseline to study completion. Eighty-eight per cent of questionnaire respondents were satisfied with the service. Interviews indicated care plan acceptability, patient satisfaction, empowerment, and service enthusiasm. Identified barriers to the consultations included time and technology. This study developed a feasible, effective, well-perceived community pharmacy diabetes care plan in Nigeria.

摘要

本研究以大多来自高收入国家的现有研究为依据,旨在为低收入和中等收入国家(尼日利亚)的2型糖尿病患者制定并测试一项以社区药房为基础的以人为本的目标设定干预措施的可行性。医学研究理事会(MRC)关于制定复杂干预措施的指南为干预措施的制定提供了框架。患者在六个月内每月参加社区药剂师咨询。在基线和研究结束时收集自我报告和临床结果指标,并在STATA V.14中进行分析。20家药房的20名药剂师完成了研究并招募了104名患者。其中,89名患者有完整的研究数据,70名患者还完成了研究后评估问卷。此外,还对15名患者和10名药剂师进行了访谈。所有结果指标均显示出统计学上的显著改善(<0.05)。临床结果(体重指数、腰围和空腹血糖)有显著改善。患者激活量表(PAM©)、生活质量(EQ-VAS©)和药物依从性从基线到研究结束均有所改善。88%的问卷受访者对该服务表示满意。访谈表明护理计划具有可接受性、患者满意度高、患者得到了赋权且服务热情高涨。确定的咨询障碍包括时间和技术问题。本研究在尼日利亚制定了一项可行、有效且得到良好认可的社区药房糖尿病护理计划。

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