文章摘要
宋智慧,季文媛,刘海莹,魏秀凤,朱晓蓉,王家伟.2型糖尿病住院患者药物治疗管理模式的效果评价[J].中国药事,2024,38(6):705-711
2型糖尿病住院患者药物治疗管理模式的效果评价
Evaluation of the Effect of Medication Therapy Management Model inHospitalized Patients with Type 2 Diabetes
投稿时间:2024-02-02  
DOI:10.16153/j.1002-7777.2024.06.012
中文关键词: 2 型糖尿病  临床药师  药物治疗管理  队列研究
英文关键词: type 2 diabetes  clinical pharmacist  medication therapy management  cohort study
基金项目:北京药学会临床药学研究项目(编号 LCYX202214)
作者单位
宋智慧 首都医科大学附属北京同仁医院北京 100730 
季文媛 首都医科大学附属北京世纪坛医院北京 100038 
刘海莹 北京市房山区燕山医院北京 102500 
魏秀凤 首都医科大学附属北京同仁医院北京 100730 
朱晓蓉 首都医科大学附属北京同仁医院北京 100730 
王家伟 首都医科大学附属北京同仁医院北京 100730 
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中文摘要:
      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。
英文摘要:
      Objective: To evaluate the eff ect of medication therapy management model for hospitalized patientswith diabetes mellitus type 2 (T2DM), and to explore a pharmacy service model suitable for China. Methods: Thestudy subjects were T2DM patients admitted to the Department of Endocrinology, Beijing Tongren Hospital, fromOctober 1, 2022 to September 30, 2023. Patients who satisfi ed the standard of alloxia were divided into clinicalpharmacist 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 routinelycarrying out the review of medical prescriptions, discharge education, and medication counseling. Comparison ofthe 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 123males, 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 ofmetformin, GLP-1Ra, SGLT2i, and statins in the clinical pharmacist management group were signifi cantly higherthan those in the routine management group (P<0.05), and further subgroup analyses showed that the applicationrates of preferably used drugs were signifi cantly higher in ASCVD and DKD patients in the clinical pharmacistmanagement group compared with those in routine management group (P<0.05); after discharge, the compliancerates of HbA1c, blood pressure, and low density lipoprotein cholesterol(LDL-c) in the clinical pharmacistmanagement group were signifi cantly higher than routine management group (P<0.05); however, there was nosignifi cant diff erence in inpatient drug costs and adverse reactions (P>0.05). Conclusion: Clinical pharmacistscarried out pharmaceutical care in the mode of medication therapy management model for inpatient with type 2diabetes mellitus, is benefi cial to the optimization of medication therapy and the improvement of clinical treatmenteff ects.
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