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马来西亚雪兰莪地区2型糖尿病患者参加药剂师管理的药物依从性诊所对血糖控制及未完成治疗风险因素的影响。

Impact of Attendance to a Pharmacist-Managed Medication Adherence Clinic on Glycemic Control and Risk Factors for Non-Completion Among Persons with Type 2 Diabetes Mellitus in Selangor, Malaysia.

作者信息

Hassan Fahmi, Hatah Ernieda, Chong Wei Wen, Ali Adliah Mhd

机构信息

Fakulti Farmasi, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Jabatan Farmasi, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.

出版信息

Ther Clin Risk Manag. 2024 Aug 12;20:495-503. doi: 10.2147/TCRM.S442026. eCollection 2024.

Abstract

BACKGROUND

Diabetes mellitus (DM) is a chronic metabolic disorder affecting millions globally. Adherence to treatment is crucial for effective management.

OBJECTIVE

To compare clinical outcomes, specifically changes in haemoglobin A1c (HbA1c) and fasting blood sugar (FBS) levels, between DM patients who completed the pharmacist-managed Diabetes Medication Therapy Adherence Clinic (DMTAC) sessions and those who did not, and to identify risk factors associated with non-completion of DMTAC.

METHODS

This multicenter, retrospective study included patients with DM attending DMTAC at five Ministry of Health centers from January 2018 to December 2020. Patients were categorized based on their completion of DMTAC sessions: those who completed at least four sessions and those who did not as per DMTAC protocol. The changes in HbA1c and FBS levels between the groups were analyzed. Logistic regression was employed to identify risk factors for non-completion of DMTAC.

RESULTS

A total of 198 patients were included, comprising 49% male with a mean age of 56.52, ±12.91 years. The complete group consisted of 49% (n=99) of the patients, while the did not complete group included 50.5% (n=100). A statistically significant reduction in FBS levels from initial to final measurements was observed in the complete group compared to the did not complete group (P=0.024). Female gender, higher education levels, and a longer duration since DM diagnosis were significantly associated with non-completion of DMTAC.

CONCLUSION

Diabetic patients attending at least four DMTAC sessions showed potential improvements in FBS levels. To enhance attendance at DMTAC sessions, healthcare professionals should focus on patients identified with risk factors for non-completion of DMTAC.

摘要

背景

糖尿病(DM)是一种慢性代谢紊乱疾病,全球有数以百万计的人受其影响。坚持治疗对于有效管理至关重要。

目的

比较完成药剂师管理的糖尿病药物治疗依从性诊所(DMTAC)疗程的糖尿病患者与未完成疗程的患者之间的临床结局,特别是糖化血红蛋白(HbA1c)和空腹血糖(FBS)水平的变化,并确定与未完成DMTAC相关的风险因素。

方法

这项多中心回顾性研究纳入了2018年1月至2020年12月在五个卫生部中心参加DMTAC的糖尿病患者。根据患者完成DMTAC疗程的情况进行分类:按照DMTAC方案,完成至少四个疗程的患者和未完成的患者。分析两组之间HbA1c和FBS水平的变化。采用逻辑回归确定未完成DMTAC的风险因素。

结果

共纳入198例患者,其中男性占49%,平均年龄为56.52±12.91岁。完成组包括49%(n = 99)的患者,未完成组包括50.5%(n = 100)。与未完成组相比,完成组从初始测量到最终测量的FBS水平有统计学意义的降低(P = 0.024)。女性、较高的教育水平以及糖尿病诊断后的较长病程与未完成DMTAC显著相关。

结论

参加至少四个DMTAC疗程的糖尿病患者的FBS水平显示出潜在改善。为提高DMTAC疗程的参与率,医疗保健专业人员应关注那些被确定为有未完成DMTAC风险因素的患者。

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