连接护理环节：一项试点研究，利用医院药剂师将原住民和/或托雷斯海峡岛民与医院的糖尿病护理联系起来。

Connecting the Dots of Care: A pilot study linking Aboriginal and/or Torres Strait Islander peoples with diabetes care in hospital, using hospital pharmacists.

作者信息

Welch Susan, Moles Rebekah, Viardot Alexander, Deweerd Pauline, Daly Scott, Lee Kylie

机构信息

St. Vincent's Hospital, 390 Victoria St., Darlinghurst 2010, Australia.

University of Sydney, School of Pharmacy, Faculty of Medicine and Health, Camperdown, Sydney, N.S.W 2006, Australia.

出版信息

Explor Res Clin Soc Pharm. 2023 Oct 14;12:100351. doi: 10.1016/j.rcsop.2023.100351. eCollection 2023 Dec.

DOI:10.1016/j.rcsop.2023.100351

PMID:37965249

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10641541/

Abstract

BACKGROUND

Diabetes is common among Aboriginal and/or Torres Strait Islander peoples, yet often undetected in hospital.

OBJECTIVE

To identify how urban hospital pharmacists can detect if Aboriginal and/or Torres Strait Islander patients have diabetes or a higher chance of getting diabetes.

METHODS

A multi-methods study used data from patients, and researcher field notes. Aboriginal and/or Torres Strait Islander peoples admitted to hospital over 12-weeks (July-October 2021) were prospectively identified from admissions lists. A hospital pharmacist-researcher visited eligible patients. Consenting participants had their blood glucose and HbA1c checked. Participants with HbA1c > 6.5% (no known diabetes) or 7% (known diabetes) were referred for endocrinology review during their stay. Test results and resultant diabetes plan were shared with their general practitioner. Two days after discharge, participants were called to gauge views on their hospital-based diabetes care. Barcode technology recorded pharmacist time. Voice-recorded field notes were thematically analysed. Ethics approval was obtained.

RESULTS

Seventy-two patients were eligible for inclusion, 67/72 (93%) consented to take part. Sixty-one (91%) patients returned a HbA1c < 6.5, of which, 4/61 (6.5%) returned a HbA1c, 6-6.4. They were contacted to yarn about diabetes prevention. Six of the 67 (9%) qualified for endocrine review, 5 had known diabetes, one newly diagnosed. None were known to endocrinology. All participants telephoned were satisfied with their hospital-based diabetes care. Pharmacist time for initial introductory yarn, consenting process, organisation of HbA1c and results discussion was 20 min or 40 min if referred for endocrine review. Field notes guided understanding of service implementation.

CONCLUSION

This novel pharmacist-led diabetes screening service for Aboriginal and/or Torres Strait Islander peoples appeared to provide a unique opportunity for screening and referral links in a holistic way. Future research is required to test this model by upscaling to include more pharmacists and other chronic disease screening and referral pathways.

摘要

背景

糖尿病在原住民和/或托雷斯海峡岛民中很常见，但在医院中往往未被发现。

目的

确定城市医院药剂师如何检测原住民和/或托雷斯海峡岛民患者是否患有糖尿病或患糖尿病的几率更高。

方法

一项多方法研究使用了患者数据和研究人员的实地记录。从入院名单中前瞻性地识别出在12周内（2021年7月至10月）入院的原住民和/或托雷斯海峡岛民。一名医院药剂师研究人员拜访了符合条件的患者。同意参与的参与者接受了血糖和糖化血红蛋白（HbA1c）检查。HbA1c>6.5%（无已知糖尿病）或7%（已知糖尿病）的参与者在住院期间被转介至内分泌科进行复查。检测结果和由此产生的糖尿病治疗计划与他们的全科医生共享。出院两天后，联系参与者以了解他们对基于医院的糖尿病护理的看法。条形码技术记录药剂师的时间。对语音记录的实地记录进行了主题分析。获得了伦理批准。

结果

72名患者符合纳入条件，67/72（93%）同意参与。61名（91%）患者的HbA1c<6.5，其中4/61（6.5%）的HbA1c为6 - 6.4。与他们联系以讨论糖尿病预防。67名（9%）中有6名符合内分泌科复查条件，5名已知患有糖尿病，1名新诊断出糖尿病。内分泌科均不了解这些患者。所有接受电话随访的参与者对基于医院的糖尿病护理都很满意。药剂师进行初步介绍性交谈、同意过程、组织HbA1c检测和结果讨论的时间为20分钟，如果转介至内分泌科复查则为40分钟。实地记录有助于理解服务的实施情况。