Western New England University College of Pharmacy and Health Sciences, Springfield, Massachusetts.
Baystate Medical Center, Springfield, Massachusetts.
Sci Diabetes Self Manag Care. 2024 Oct;50(5):418-427. doi: 10.1177/26350106241268413. Epub 2024 Aug 12.
The purpose of this study was to determine the effectiveness of pharmacist-led interventions on diabetes distress and glucose management among people with type 2 diabetes (T2DM) in a community care clinic.
Adults with T2DM were recruited during routine visits at the pharmacist-run clinic. Participants completed a baseline A1C, demographic survey, Diabetes Distress Scale (DDS), and Patient Health Questionnaire-2 (PHQ-2). Depending on DDS subscale-specific responses, participants qualified for pharmacist-led educational interventions based on the ADCES7 Self-Care Behaviors™. After 6 months, participants completed another A1C, satisfaction survey, DDS, and PHQ-2. Data analysis included descriptive statistics and paired tests.
Among 53 participants at baseline, diabetes distress was present in 77.4%; emotional burden was most common in 64.2%, followed by regimen distress in 45.3%, interpersonal distress in 34.0%, and physician distress in 20.8%. After the intervention, significant reductions occurred in mean overall DDS score (2.0 to 1.7), emotional burden (2.4 to 1.8), regimen distress (2.3 to 1.7), A1C (7.0% to 6.5%; 53.0 to 47.5 mmol/mol), and PHQ-2 score (1.6 to 1.0). Participants were highly satisfied with the service, their knowledge, and self-management skills following completion of the study.
Diabetes distress was present in most participants despite glucose management that was largely achieving treatment goals. Pharmacist-led educational interventions significantly reduced overall DDS score, emotional burden, regimen distress, A1C, and PHQ-2 score. The results of this study suggest that people with T2DM should receive routine screening for diabetes distress and that pharmacists can positively affect diabetes management and emotional well-being through tailored education.
本研究旨在确定药剂师主导的干预措施在社区护理诊所中对 2 型糖尿病(T2DM)患者的糖尿病困扰和血糖管理的有效性。
在药剂师管理的诊所常规就诊期间招募 T2DM 成年人。参与者完成基线 A1C、人口统计学调查、糖尿病困扰量表(DDS)和患者健康问卷-2(PHQ-2)。根据 DDS 亚量表的具体反应,参与者根据 ADCES7 自我护理行为™有资格接受药剂师主导的教育干预。6 个月后,参与者完成了另一次 A1C、满意度调查、DDS 和 PHQ-2。数据分析包括描述性统计和配对 t 检验。
在基线时的 53 名参与者中,77.4%存在糖尿病困扰;情绪负担最常见,占 64.2%,其次是治疗方案困扰占 45.3%、人际困扰占 34.0%和医生困扰占 20.8%。干预后,平均总体 DDS 评分(2.0 降至 1.7)、情绪负担(2.4 降至 1.8)、治疗方案困扰(2.3 降至 1.7)、A1C(7.0%降至 6.5%;53.0 降至 47.5mmol/mol)和 PHQ-2 评分(1.6 降至 1.0)均显著降低。参与者对服务、知识和完成研究后的自我管理技能非常满意。
尽管血糖管理在很大程度上达到了治疗目标,但大多数参与者仍存在糖尿病困扰。药剂师主导的教育干预显著降低了总体 DDS 评分、情绪负担、治疗方案困扰、A1C 和 PHQ-2 评分。这项研究的结果表明,T2DM 患者应接受常规的糖尿病困扰筛查,药剂师可以通过量身定制的教育对糖尿病管理和情绪健康产生积极影响。