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基于在中国识别出的患者及医生与用药相关的问题,由药师主导的2型糖尿病用药培训的有效性

Effectiveness of Pharmacist-Led Training Regarding Medication for Type 2 Diabetes, Based on Patient and Physician Medication-Related Issues Identified in China.

作者信息

Yang Zhong Hui, Cheng Chang Juan, Chen Guo Mei, Huang Ji, Zhou Hai, Jiang Jie, Ye Zhen, Weng Yu Fang, Tan Hai Hong

机构信息

Department of Pharmacy, Taicang First People's Hospital, Soochow University, Taicang, Jiangsu, People's Republic of China.

Health Service Center of Chengxiang Town, Taicang, Jiangsu, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2025 Apr 24;18:1285-1298. doi: 10.2147/DMSO.S512518. eCollection 2025.

Abstract

AIM

To determine the effect of pharmacist-led specialized medication training on rational drug prescription by family physicians, and to characterize the drug-related issues and glycemic control of patients.

METHODS

We performed a study led by clinical pharmacists. Using surveys of medication use by doctors and patients, a 1-year training program was developed to improve the knowledge of family physicians regarding appropriate drug use. It consisted of an initial survey to assess both physician knowledge and patient medication use, followed by a training program designed to address the identified deficiencies. The program comprised quarterly group training sessions focusing on medication updates, guidelines, and clinical case discussions. Cross-sectional sampling was performed before and after doctors' intervention, carry out a questionnaire survey and compare the questionnaire scores. Patients were randomly sampled before intervention, medication problems were investigated before and after intervention. The effects of the intervention were evaluated by comparing the survey results before and after, with focuses on drug knowledge, rational prescribing, and patient outcomes such as blood glucose control.

RESULTS

Before and after the intervention, 120 valid questionnaires were collected from family doctors in each group. Both groups were principally composed of general practitioners with primary titles, but most had 0-5 years of experience, followed by >20 years. A total of 361 patients were sampled (174 men; mean age 66.8±9.62 years), of whom 215 (59.6%) had had type 2 diabetes for 6-15 years, and 126 (34.9%) had had the disease for ≤5 years. After the training, the score had significantly improved, from 32.67±6.14 to 37.12±6.24 (<0.05), and there were fewer misunderstandings about oral and injectable medications (<0.05). The number of patients with medication issues decreased by 55.0% (from 171 to 77, <0.05), and their mean fasting plasma glucose concentration (FPG) had also significantly decreased (<0.05).

CONCLUSION

The intervention studied improved family physicians' knowledge of medication for type 2 diabetes, reduced the number of medication issues for patients, and improved their FPG concentrations. It should provide a valuable reference for chronic disease management. This pharmacist-led training approach could be expanded to improve medication practices and patient outcomes on a larger scale, particularly for the purposes of chronic disease management. By including such programs, medication-related issues could be reduced in number and overall treatment effectiveness could be enhanced.

摘要

目的

确定由药剂师主导的专业药物培训对家庭医生合理用药处方的影响,并描述患者的药物相关问题及血糖控制情况。

方法

我们开展了一项由临床药剂师主导的研究。通过对医生和患者的用药情况进行调查,制定了一个为期1年的培训项目,以提高家庭医生关于合理用药的知识。该项目包括一项初始调查,以评估医生的知识水平和患者的用药情况,随后是一个旨在解决已发现不足的培训项目。该项目包括每季度一次的小组培训课程,重点是药物更新、指南和临床病例讨论。在医生干预前后进行横断面抽样,开展问卷调查并比较问卷得分。在干预前对患者进行随机抽样,调查干预前后的用药问题。通过比较前后调查结果评估干预效果,重点关注药物知识、合理处方以及患者结局,如血糖控制情况。

结果

干预前后,每组从家庭医生处收集到120份有效问卷。两组主要由具有初级职称的全科医生组成,但大多数医生有0至5年的经验,其次是超过20年经验的医生。总共抽取了361例患者(174名男性;平均年龄66.8±9.62岁),其中215例(59.6%)患有2型糖尿病6至15年,126例(34.9%)患有该疾病≤5年。培训后,得分显著提高,从32.67±6.14提高到37.12±6.24(<0.05),对口服和注射药物的误解减少(<0.05)。有用药问题的患者数量减少了55.0%(从171例降至77例,<0.05),他们的平均空腹血糖浓度(FPG)也显著降低(<0.05)。

结论

本研究中的干预措施提高了家庭医生对2型糖尿病用药的知识水平,减少了患者的用药问题数量,并改善了他们的FPG浓度。它应为慢性病管理提供有价值的参考。这种由药剂师主导的培训方法可以扩大规模,以改善用药实践和患者结局,特别是为了慢性病管理的目的。通过纳入此类项目,可以减少与药物相关的问题数量,并提高总体治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3270/12042202/263dda8944a5/DMSO-18-1285-g0001.jpg

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