基于药师自主开发软件实施的门诊糖尿病患者药物治疗管理模式构建及效果评价

Construction and effect evaluation of medication therapy management model for diabetic outpatients based on the software independently developed by pharmacists

目的基于药师自主研发的小程序软件,探索门诊2型糖尿病患者“互联网+药物治疗管理(MTM)”的药学服务模式,评价其药学服务效果。方法选取2021年5月至2023年8月我院药学门诊就诊的糖尿病患者,开展“互联网+MTM”服务6个月后,通过比较药学服务前后患者相关糖尿病综合指标、用药依从性评分、糖尿病知识问答得分、低血糖和药物不良反应(ADR)发生情况,以及患者满意度,评估“互联网+MTM”模式的药学服务效果。结果共142例2型糖尿病患者完成6个月MTM管理,患者糖化血红蛋白由7.83%±1.37%降至6.83%±0.72%,收缩压由(133.13±13.05)mmHg降至(129.13±8.95)mmHg,舒张压由(81.48±10.62)mmHg降至(80.72±8.19)mmHg,空腹血糖由(9.21±2.59)mmol/L降至(6.65±1.48)mmol/L,差异均有统计学意义(P<0.05)。患者依从性评分有明显改善,依从性评分8分(即依从性好)例数由7例升至30例,依从性评分<6分(即依从性差)例数由60例降至9例,差异均有统计学意义(P<0.001)。患者糖尿病认知得分由(11.46±2.43)分升至(13.05±2.07)分(P<0.001),满意度得分由(11.82±2.08)分升至(13.68±1.85)分(P<0.001)。管理期间ADR发生率为9.86%,低血糖例数由前期13例降至2例,药学服务期间无严重低血糖事件发生。结论药师通过自主研发的小程序软件开展MTM,在2型糖尿病患者治疗中发挥了积极作用,“互联网+MTM”拓展了药学服务空间,提升了药师工作效率。

Objective To explore the pharmaceutical service mode of"Internet+Medication Therapy Management(MTM)"for outpatients with type 2 diabetes and evaluate its effect based on the small program software independently developed by pharmacists.Methods Diabetic patients from Pharmacy Clinic in our hospital were selected from May 2021 to August 2023.After 6 months of"Internet+MTM"service,the effect of pharmaceutical service of the"Internet+MTM"mode was evaluated by comparing the comprehensive indicators of diabetes in patients,medication compliance scores,scores of diabetes knowledge,the incidence of hypoglycemia and ADR,and the satisfaction degree of patients before and after pharmaceutical services.Results Totally 142 patients with type 2 diabetes completed 6-month MTM management.After 6 months of MTM management,the HbA1c of the patients decreased from 7.83%±1.37%to 6.83%±0.72%(P<0.05);the systolic blood pressure was decreased from(133.13±13.05)mmHg to(129.13±8.95)mmHg(P<0.05);the diastolic blood pressure was decreased from(81.48±10.62)mmHg to(80.72±8.19)mmHg(P<0.05);the fasting blood glucose was decreased from(9.21±2.59)mmol/L to(6.65±1.48)mmol/L(P<0.05).After 6 months of MTM management,the score of patient's compliance was improved obviously.The number of patients with compliance score of 8 points(good compliance)increased from 7 to 30(P<0.001),while the number of patients with compliance score less than 6 points(poor compliance)decreased from 60 to 9(P<0.001).After 6 months of MTM management,the diabetes cognitive score of patients was increased from(11.46±2.43)to(13.05±2.07)(P<0.001),and the satisfaction degree was also increased from(11.82±2.08)to(13.68±1.85)(P<0.001).The incidence of ADR was 9.86%during the management.The number of patients with hypoglycemia decreased from 13 to 2,and there was no serious hypoglycemia case during the pharmaceutical service period.Conclusion Pharmacists carry out MTM through self-developed small program software and play an active role in the treatment of patients with type 2 diabetes."Internet+MTM"expands the space of pharmaceutical service and improves the work effectiveness of pharmacists.