临床药师主导老年2型糖尿病患者管理的效果分析

Analysis of the effect of clinical pharmacist leading management of elderly patients with type 2 diabetes

目的探讨临床药师主导的老年2型糖尿病患者管理模式对改善血糖临床指标和药物不良反应的影响。方法选择2019年1—9月在福建医科大学附属泉州第一医院内分泌科住院的100例老年2型糖尿病患者作为研究对象,按照随机数字表法分为对照组(n=50)和观察组(n=50),对照组患者采用本院传统的慢性疾病管理模式,观察组患者在原来慢性疾病管理模式的基础上增加了临床药师的主动干预,包括药物重整、医嘱审核、用药咨询、用药教育、用药监护,对所有患者随访6个月,观察两组患者在干预前后空腹血糖(FPG)、餐后2小时血糖(2 h PG)、糖化血红蛋白(HbA1c)和低血糖等药物不良反应的变化情况。结果观察组患者干预后的FPG、2 h PG、HbA1c和药物不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论临床药师主导老年2型糖尿病管理可提高老年患者用药的有效性和安全性,为构建新的慢性疾病管理药学服务模式提供了参考。

Objective To investigate the influence of the clinical pharmacist leading management mode for elderly patients with type 2 diabetes(T2D)on improving the clinical indicators of blood glucose and the adverse drug reactions.Methods A total of 100 elderly T2D patients who were hospitalized in the endocrinology department of Quanzhou First Hospital Affiliated to Fujian Medical University from January to September 2019 were selected as the study subjects and divided into the control group(n=50)and the observation group(n=50)according to the random number table method.The control group used traditional chronic disease management mode of our hospital,while patients in the observation group also received active intervention of clinical pharmacist in addition to the original chronic disease management,including medication reconciliation,medical order review,medication consultation,medication education,and medication monitoring.All patients were followed up for 6 months to observe the changes fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),and the hypoglycemia and other adverse drug reactions before and after intervention in the two groups.Results The levels of FPG,2 h PG,HbA1c and total incidence of adverse drug reactions in the observation group after intervention were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion The clinical pharmacist leading management of elderly T2D patients can improve the effectiveness and safety of medication for elderly patients,and provide a reference for constructing a new chronic disease management pharmaceutical service mode.