2型糖尿病患者药学监护路径的建立及应用

Establishment and Application of Pharmaceutical Care Pathway for the Patients with Type 2 Diabetes

目的:建立2型糖尿病患者药学监护路径(PCP),为开展规范化糖尿病药学服务提供思路。方法:100例2型糖尿病患者随机分为对照组(n=50)和监护组(n=50)。应用临床路径的方法和原理,按糖尿病治疗特点,建立2型糖尿病患者PCP并用于监护组患者,对照组患者则给予常规管理。随访6个月后比较两组患者不合理用药发生率、糖尿病主要控制指标情况、自我管理水平、疾病认知情况和相关药物知识了解情况。结果:与对照组比较,监护组患者的不合理用药发生率,糖尿病主要监测指标空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbAlc)、收缩压(SBP)和舒张压(DBP)情况,自我管理水平(用药依从性、每天监测血糖、饮食、睡眠)、对疾病的认知情况(相关指标控制水平、并发症、饮食、运动、吸烟、饮酒)和对糖尿病药物相关知识的了解情况(降糖药的种类、降糖药的作用机制、降糖药的使用时间、降糖药的不良反应、胰岛素名称)等各项指标均优于对照组(P<0.05)。结论:采用本研究制定的2型糖尿病PCP对患者进行药学监护,有利于保障患者的合理用药,改善患者的糖尿病相关控制指标,提高患者的自我管理水平、对疾病的认知及相关药物知识的了解水平。

Objective:To establish the pharmaceutical care pathway(PCP)for the patients with type 2 diabetes to provide ideas for the development of standardized diabetic pharmaceutical services.Methods:A total of 100 type 2 diabetes patients were selected in the study and divided randomly into two groups:the control group(n=50)and the care group(n=50).According to the principles and methods of clinical pathway and the characteristics of diabetes treatment,the PCP for the patients with type 2 diabetes was established and applied to the care group.The regular management was given to the control group.The incidence of unreasonable prescription,control level of index,level of self-management,cognition of disease and knowledge related to diabetes drugs were analyzed after 6-month following up in the two groups.Results:After the treatment,the unreasonable prescription,control level of indices about fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc),systolic blood pressure(SBP)and diastolic blood pressure(DBP),level of self-management about medication adherence,blood sugar monitoring,diet and sleep,cognition of disease about control level,complication,diet,exercise,smoking and alcohol,and knowledge related to diabetes drugs about the type of medication,the mechanism of medication,use of time,medicines adverse reactions and the names of insulin in the care group were better than those in the control group(P<0.05).Conclusion:Establishment and application of the PCP for the patients with type 2 diabetes are beneficial to the patients to ensure the rational medication and improve the level of diabetes control indices,self-management,awareness of diabetes diseases and knowledge of related drugs.