全程药学服务对糖尿病患者用药依从性及健康行为的影响

Effects of whole-course pharmaceutical care on medication compliance and health behavior in patientswith diabetes mellitus

目的分析全程药学服务对糖尿病患者用药依从性及健康行为的影响。方法选取2019年10月至2020年10月于本院治疗的68例2型糖尿病患者作为研究对象,随机分为观察组与对照组,每组34例。对照组给予常规用药指导,观察组给予全程药学服务指导,比较干预前、干预4周、干预12周后两组糖代谢[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)]水平,干预前、干预12周后用药依从性[中文版8条目Morisky服药依从性量表(MMAS-8)]及健康行为[糖尿病自我效能量表中文版-短版(CDES-SF)、自我照顾(DSCS)],用药期间药物不良事件(方法错误、剂量错误)发生率。结果干预前、干预4周、干预12周,两组FBG、2 h PBG、HbA1c水平呈下降趋势(P<0.05);干预4周及干预12周后,观察组FBG、2 h PBG、HbA1c水平均低于对照组(P<0.05)。干预12周后,观察组用药依从性高于干预前,且观察组高于对照组(P<0.05);干预12周后,两组CDES-SF、DSCS评分均高于干预前,且观察组高于对照组(P<0.05)。观察组不良事件发生率为8.82%,低于对照组的29.41%(P<0.05)。结论对糖尿病患者实施全程药学服务,可有效控制血糖水平,提高用药依从性及自我效能,促进自我照顾,减少不良事件发生。

Objective To analyze the effects of whole-coursepharmaceutical care on medication compliance and health behavior in patients with diabetes mellitus.Methods 68 patients with type 2 diabetes mellitus treated in the hospital from October 2019 to October 2020 were selected as the research subjects,and they were randomly divided into observation group and control group,with 34 cases in each group.The control group was given routine medication guidance,and the observation group was given whole-course pharmaceutical care guidance.The glucose metabolism(fasting blood glucose[FBG],2 h postprandial blood glucose[2 h PBG],glycated hemoglobinA1c[HbA1c])before intervention and after 4 weeks and 12 weeks of intervention,medication compliance(Chinese version of 8-item Morisky medication adherence scale[MMAS-8])and health behavior(Chinese version of diabetes self-efficacy scale-short form[CDES-SF],diabetes self-care scale[DSCS])before intervention and after 12 weeks ofintervention and incidence rates of adverse drug events(method error,dosage error)during medication were compared between the two groups.Results Before intervention and after4 weeks and 12 weeks of intervention,the levels of FBG,2 h PBG and HbA1c showed decreasing trends(P<0.05).The FBG,2 h PBG and HbA1c levels in observation group after 4 weeks and 12 weeks of interventionwere lower than those in control group(P<0.05).After 12 weeks of intervention,the medication compliance was higher than that before intervention,and the compliance in observation group was higher compared to control group(P<0.05).The scores of CDES-SF and DSCS in two groups were higher after 12 weeks of intervention than those before intervention,and the scores in observation group were higher than those in control group(P<0.05).The incidence rate of adverse events in observation group was 8.82%,which was lower than 29.41%in control group(P<0.05).Conclusion Whole-course pharmaceutical care for patients with diabetes mellitus can effectively control blood glucose level,enhance medication compliance and self-efficacy,promote self-care and reduce adverse events.