To determine the impact of a pharmaceutical care programme (PCP) in diabetic patients.
Randomised controlled study of high-risk diabetic patients.
Outpatient clinic at Fremantle hospital (FH), Western Australia.
Patients over 18 years of age who could communicate freely in English and fulfilled pre-determined criteria for being high-risk for the development of diabetic complications, were randomly assigned to the PCP or control groups in a ratio of 2:1. In the PCP arm, a clinical pharmacist reviewed and monitored all aspects of the patients' drug therapy in collaboration with other health care professionals at six-weekly intervals for six months. The control patients received usual outpatient care.
Glycosylated haemoglobin (HbA1c), quality of life (QOL), patient satisfaction with health care providers and changes in drug therapy during the PCP.
Seventy-three patients were recruited into the study, of whom 48 (66 per cent) were randomised to the PCP. There were no significant differences between the PCP (cases) and the control groups for demographic variables. The mean (±SD) HbA1c for the cases was 8.4±1.4 per cent at the beginning and 8.2±1.5 per cent at the end of the study period (P>0.05). There was similarly no change in the control group (8.5±1.6 per cent to 8.1±1.6 % P>0.05). There were no significant changes in QOL for cases or controls over the period of the study. During the PCP, there was a significant increase in patient satisfaction with the care provided by the clinical pharmacist (P=0.007) and the provision of drug information (P=0.036). The clinical pharmacist facilitated 39 drug interventions in the 48 cases. A high level of complementary medicine usage was found in the PCP group (16.7 per cent).
PCPs provide patients with important medication information and result in changes to drug therapy. However, in diabetic patients under specialist care, a six-month PCP did not lead to an improvement in glycaemic control. The role for pharmacist intervention in primary care now needs to be evaluated.
确定药学护理计划(PCP)对糖尿病患者的影响。
对高危糖尿病患者进行随机对照研究。
西澳大利亚州弗里曼特尔医院(FH)门诊。
年龄超过18岁,能够自由用英语交流,并符合预先确定的高危糖尿病并发症发展标准的患者,按2:1的比例随机分配到PCP或对照组。在PCP组中,临床药剂师与其他卫生保健专业人员合作,每6周监测和审查患者药物治疗的所有方面,共持续6个月。对照组患者接受常规门诊护理。
糖化血红蛋白(HbA1c),生活质量(QOL),患者对卫生保健提供者的满意度以及PCP期间药物治疗的变化。
共招募了73名患者,其中48名(66%)随机分配到PCP组。PCP(病例)组和对照组在人口统计变量方面没有显著差异。在研究期开始时,病例组的平均(±SD)HbA1c为8.4±1.4%,在研究期结束时为8.2±1.5%(P>0.05)。对照组也没有变化(8.5±1.6%至8.1±1.6%P>0.05)。在研究期内,病例组和对照组的QOL都没有显着变化。在PCP期间,患者对临床药剂师提供的护理满意度显著提高(P=0.007),以及药物信息的提供(P=0.036)。临床药剂师在48个病例中进行了39次药物干预。PCP组中发现了高水平的补充医学使用(16.7%)。
PCP为患者提供重要的药物信息,并导致药物治疗的变化。然而,在接受专科护理的糖尿病患者中,6个月的PCP并没有导致血糖控制的改善。现在需要评估药剂师干预在初级保健中的作用。