摘要
目的:对2型糖尿病(T2DM)住院患者药物治疗管理模式进行效果评估,探索适合我国的药学服务模式。方法:研究对象为2022年10月1日-2023年9月30日北京同仁医院内分泌科入院的T2DM患者,将符合纳入标准的患者分为临床药师管理组和常规管理组。临床药师管理组,在常规开展医嘱审核、出院教育、用药咨询等工作外,还会深度参与患者个体化方案制定,给予详细的用药指导和健康教育等,出院后定期随访。比较两组患者出院3个月时的血糖、血压、血脂控制情况等。结果:纳入临床药师管理组221例,其中女性98例,男性123例,中位年龄59(43.5,67.0)岁;常规管理组217例,女性74例,男性143例,中位年龄55(42.0,56.0)岁。临床药师管理组患者宜优选使用的二甲双胍、GLP-1Ra、SGLT2i、他汀类药物应用率均显著高于常规管理组(P<0.05);进一步的亚组分析结果显示,临床药师管理组的动脉粥样硬化心血管疾病(ASCVD)患者、糖尿病肾病(DKD)患者中宜优选药物的应用率较常规管理组明显升高(P<0.05);出院后,临床药师管理组患者糖化血红蛋白(HbA1c)、血压、低密度脂蛋白胆固醇(LDL-c)的达标率较常规管理组均明显提高(P<0.05);但在住院药品费用方面、不良反应方面无明显差异(P>0.05)。结论:临床药师对T2DM住院患者开展药物治疗管理模式的药学服务,有利于优化药物治疗方案,提高临床治疗效果。
Objective:To evaluate the eff ect of medication therapy management model for hospitalized patients with diabetes mellitus type 2(T2DM),and to explore a pharmacy service model suitable for China.Methods:The study subjects were T2DM patients admitted to the Department of Endocrinology,Beijing Tongren Hospital,from October 1,2022 to September 30,2023.Patients who satisfied the standard of alloxia were divided into clinical pharmacist management group and routine management group.In clinical pharmacist management group,Clinical pharmacist management group would also be deeply involved in the patients'individualized treatment program,detailed medication guidance and health education,and follow up regularly after discharge,in addition to routinely carrying out the review of medical prescriptions,discharge education,and medication counseling.Comparison of the two groups of patients'blood glucose,blood pressure,blood lipid control at 3 months after discharge.Results:Total of 221 patients were included in the clinical pharmacist management group,including 98 females and 123 males,with a median age of 59(43.5,67.0)years,and whereas 217 patients in the routine management group,74 females and 143 males included,with a median age of 55(42.0,56.0)years.The optimal application rates of metformin,GLP-1Ra,SGLT2i,and statins in the clinical pharmacist management group were significantly higher than those in the routine management group(P<0.05),and further subgroup analyses showed that the application rates of preferably used drugs were significantly higher in ASCVD and DKD patients in the clinical pharmacist management group compared with those in routine management group(P<0.05);after discharge,the compliance rates of HbA1c,blood pressure,and low density lipoprotein cholesterol(LDL-c)in the clinical pharmacist management group were significantly higher than routine management group(P<0.05);however,there was no significant diff erence in inpatient drug costs and adverse reactions(P>0.05).Conclusion:Clinical pharmacists carried out pharmaceutical care in the mode of medication therapy management model for inpatient with type 2 diabetes mellitus,is beneficial to the optimization of medication therapy and the improvement of clinical treatment eff ects.
作者
宋智慧
季文媛
刘海莹
魏秀凤
朱晓蓉
王家伟
Song Zhihui;Ji Wenyuan;Liu Haiying;Wei Xiufeng;Zhu Xiaorong;Wang Jiawei(Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Beijing Shijitan Hospital,Beijing 100038,China;Yanshan Hospital,Beijing 102500,China)
出处
《中国药事》
CAS
2024年第6期705-711,共7页
Chinese Pharmaceutical Affairs
基金
北京药学会临床药学研究项目(编号LCYX202214)。
关键词
2型糖尿病
临床药师
药物治疗管理
队列研究
type 2 diabetes
clinical pharmacist
medication therapy management
cohort study
