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目的探究临床药师干预对糖尿病老年患者用药依从性的影响。方法选择2013-05~2015-03到本院门诊就诊的112例老年糖尿病患者为研究对象。抽签随机分为观察组和对照组,每组56例。2组均进行常规治疗,观察组在此基础上实施临床药师干预,主要手段为建立患者药历、建立个性化医嘱、加强用药监督及健康宣教。观察比较干预前后2组空腹血糖含量(FPG)、餐后2 h血糖含量(2h PG)和糖化血红蛋白(Hb A1c)水平变化,药物服用依从性及不良反应情况。结果临床药师干预后1个月,观察组FPG、2h PG、Hb A1c水平分别为(7.08±1.23)mmol/L、(11.37±1.52)mmol/L、(7.49%±0.89%),均明显低于对照组(7.93±1.45)mmol/L、(12.86±1.84)mmol/L、(8.17%±1.13%)(P<0.05);干预后3个月、6个月时观察组的依从性分别为75.00%、85.71%,均显著高于对照组55.36%、66.07%(P<0.05);干预后6个月观察组发生胃肠道不适、低血糖和腹泻的比例均分别为19.64%、3.57%、5.36%,明显低于对照组37.50%、14.29%、19.64%(P<0.05)。结论在老年糖尿病患者的治疗中引入临床药师干预,可提高患者用药依从性,利于疾病控制,具有临床推广价值。
Objective To investigate the effect of clinical pharmacist intervention on drug compliance in elderly patients with diabetes mellitus. Methods One hundred and twelve elderly patients with diabetes mellitus who were admitted to our hospital from May 2013 to 2015-03 were selected as study subjects. Lottery randomly divided into observation group and control group, 56 cases in each group. The two groups were treated routinely. On the basis of this, the observation group carried out clinical pharmacist intervention. The main measures were to establish the patient’s medical history, establish personalized medical advice, and strengthen the supervision of medication and health education. The levels of fasting blood glucose (FPG), 2h postprandial blood glucose (2h PG) and Hb A1c levels in the two groups before and after intervention were observed and compared, and their compliance and adverse reactions were observed. Results The levels of FPG, 2h PG and Hb A1c in the observation group were (7.08 ± 1.23) mmol / L, (11.37 ± 1.52) mmol / L, (7.49% ± 0.89% (7.93 ± 1.45) mmol / L, (12.86 ± 1.84) mmol / L, (8.17% ± 1.13%) in the control group (P <0.05). At 3 and 6 months after the intervention, the compliance of the observation group (75.00%, 85.71%) were significantly higher than those in the control group (55.36%, 66.07%, P <0.05). The rates of gastrointestinal discomfort, hypoglycemia and diarrhea in the observation group were 19.64% and 3.57 % And 5.36% respectively, which was significantly lower than that of the control group (37.50%, 14.29%, 19.64%, P <0.05). Conclusion The introduction of clinical pharmacist intervention in the treatment of elderly patients with diabetes can improve the compliance of patients with medication, which is conducive to disease control and has clinical promotion value.