Impact of a Community Pharmacist-Delivered Information Program on the Follow-up of Type-2 Diabetic Patients: A Cluster Randomized Controlled Study

被引：22

作者：

Michiels, Yves ^{[1
,8
]}

Bugnon, Olivier ^{[1
,8
]}

Chicoye, Annie ^{[2
]}

Dejager, Sylvie ^{[3
]}

Moisan, Christine ^{[7
]}

Allaert, Francois-Andre ^{[4
]}

Hunault, Catherine ^{[3
]}

Romengas, Laura ^{[5
]}

Mechin, Hubert ^{[5
]}

Verges, Bruno ^{[6
]}

机构：

[1] Univ Lausanne, Univ Geneva, Sch Pharmaceut Sci, Community Pharm, Lausanne, Switzerland

[2] Inst Etud Polit Paris, Paris, France

[3] MSD France, Courbevoie, France

[4] Evaluat Chair BSB Cenbiotech, Dijon, France

[5] Observia Grp, Paris, France

[6] CHU Dijon, Dept Endocrinol Diabetol & Metab Dis, Dijon, France

[7] Pitie Salpetriere, Dept Diabetol, Paris, France

[8] Univ Lausanne, Ctr Primary Care & Publ Hlth Unisante, Community Pharm, Lausanne, Switzerland

来源：

ADVANCES IN THERAPY | 2019年 / 36卷 / 06期

关键词：

Disease knowledge; Glucose control; Patient information; Pharmacist; Type; 2; diabetes; MEDICATION ADHERENCE; GLYCEMIC CONTROL; BLOOD-PRESSURE; CARE PROGRAM; REAL-WORLD; MELLITUS; INTERVENTION; OUTCOMES; MANAGEMENT; RISK;

D O I：

10.1007/s12325-019-00957-y

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

IntroductionLow-quality communication between patients and care providers and limited patient knowledge of the disease and the therapy are important factors associated with poor glycemic control in patients with type 2 diabetes. We conducted a multicenter study to determine whether structured and tailored information delivered by pharmacists to type 2 diabetic patients could improve patient treatment adherence, hemoglobin A1c (HbA1c) levels and knowledge about diabetes.MethodsOne hundred seventy-four pharmacies were randomized to deliver an educational program on diet, drug treatment, disease and complications during three 30-min interviews over a 6-month period, or to provide no intervention, to type 2 diabetic patients treated with oral antidiabetic agents. Medication adherence was assessed by measuring the medication possession ratio and diabetes control by collecting HbA1c values. Levels of patient treatment self-management and disease knowledge were assessed using self-questionnaires.ResultsThree hundred seventy-seven patients were analyzed. The medication possession ratio, already very high at baseline in the intervention (94.8%) and control (92.3%) groups, did not vary significantly after 6months with no difference between the two groups. Significant decreases in HbA1c were observed in both groups at 6months (p<0.001) and 12months (p<0.01), with significantly greater changes from baseline in the intervention group than in the control group at 6months (- 0.5% vs. - 0.2%, p=0.0047) and 12months (- 0.6% vs. - 0.2%, p=0.0057). Patients in the intervention group showed greater improvement in their ability to self-manage treatment (+ 4.86 vs. + 1.58, p=0.0014) and in the extent of their knowledge about diabetes (+ 0.6 vs. + 0.2, p<0.01) at 6months versus baseline compared with the control group.ConclusionTailored information provided by the pharmacist to patients with type 2 diabetes did not significantly improve the already high adherence rates, but was associated with a significant decrease in HbA1c and an improvement of patient knowledge about diabetes.Trial RegistrationISRCTN33776525.FundingMSD France.

引用

页码：1291 / 1303

页数：13

共 40 条

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