| 范成友,刘婧,彭松.基于信息 -动机 -行为技巧模型的药师干预对 2型糖尿病合并高血压病人糖脂代谢的影响[J].安徽医药,2021,25(8):1684-1688. |
| 基于信息 -动机 -行为技巧模型的药师干预对 2型糖尿病合并高血压病人糖脂代谢的影响 |
| Effects of IMB-model-based pharmacist intervention on the glucose and lipid metabolism of patients with type-2 diabetes and hypertension |
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| DOI：10.3969/j.issn.1009-6469.2021.08.049 |
| 中文关键词: 药学服务 信息 -动机 -行为技巧模型 药师干预 血糖达标率 血压达标率 合理用药 |
| 英文关键词: Pharmaceutical services Information-motivation-behavioral model Pharmacist intervention Blood glucose target rate Blood pressure target rate Rational drug use |
| 基金项目:安徽省“十三五”医疗卫生重点专科建设项目(皖卫教科［ 2017］30号) |
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| 中文摘要: |
| 目的探讨采用信息 -动机 -行为技巧( IMB)模型的药学干预措施对 2型糖尿病( T2DM)合并高血压病人糖脂代谢及合理用药的作用。方法纳入 2019年 1月至 2020年 6月于合肥市第一人民医院内分泌科出院的 83例 T2DM合并高血压病人作为研究对象，采用随机数字表法分为对照组 42例，观察组 41例。对照组采用常规随访措施，观察组采用基于 IMB模型的药学干预措施，干预时间为 180 d。比较干预前后收缩压( SBP)、舒张压( DBP)，空腹血糖( FPG)、糖化血红蛋白( HbA1c)、总胆固醇(TC)、三酰甘油( TG)、高密度脂蛋白( HDL-C)、低密度脂蛋白( LDL-C)；血糖、血压达标率；比较两组干预期间用药情况包括评价病人服药依从性、药物调整情况、药师建议采纳情况。结果干预后对照组 SBP［( 139.27±19.61)mmHg比( 131.15±16.62) mmHg］、 DBP［(87.69±15.47)mmHg比( 81.03±13.56)mmHg］高于观察组，血压达标率( 35.71%比 60.98%)低于观察组，差异有统计学意义( P<0.05)；干预后对照组 FPG［(8.31±2.31)mmol/L比( 7.35±1.01)mmol/L］、 HbA1c［(7.59±1.71)%比( 6.83±1.35)%］高于观察组，血糖达标率( 42.85%比 65.85%)低于观察组，差异有统计学意义( P<0.05)；干预后对照组 TC［( 6.86±1.14)mmol/L比(6.27±1.12)mmol/L］、 TG［(2.96±0.51)mmol/L比( 2.55±0.39)mmol/L］、 HDL-C［(1.69±0.33)mmol/L比( 1.31±0.29)mmol/L］、 LDL-C［( 3.69±0.71)mmol/L比( 3.23±0.51)mmol/L］水平高于观察组，差异有统计学意义( P<0.05)，干预后观察组依从性评分［( 6.87±0.91)分比( 4.41±0.72)分］高于对照组，差异有统计学意义( P<0.05)；干预期间观察组接受药师建议后就诊调整药物治疗方案例数［ 31(73.81%)比 12(28.57%)］、药师建议接受例数［ 37(90.24%)比 14(33.33%)］高于对照组，差异有统计学意义( P<0.05)。结论基于 IMB模型的药师干预措施有助于改善 T2DM合并高血压病人出院后血糖、血压达标情况，改善病人糖脂代谢情况，提高病人的用药依从性、促进病人及时调整药物治疗方案，主动接受药师建议。 |
| 英文摘要: |
| Objective Study on effects of pharmaceutical interventions dominated by IMB model on the glucose and lipid metabolism and the rational use of medicine in patients suffering type-2 diabetes(T2DM) and hypertension.Methods 83 patients with T2DMand hypertension who were discharged from the Endocrinology Department of Hefei First People's Hospital from January 2019 to June2020 were taken as the research subjects. These patients were randomly divided into two groups: 42 cases in the control group and41cases in the study group. Patients in the control group were treated with routine follow-up measures, while patients in the study group were treated with pharmaceutical intervention measures based on the information-motivation-behavioral (IMB)model for 180 days. Indicators of systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), and the eligible rates ofblood glucose and blood pressure of patients in both groups were compared before and after the intervention; meanwhile, medicine using status of patients in both groups during the intervention period was also compared, including evaluation of medication compliance,medication adjustment, and adoption of pharmacist's recommendations.Results After the intervention, the SBP[(139.27±19.61)mmHg vs.(131.15±16.62)mmHg] and DBP[(87.69±15.47)mmHg vs.(81.03±13.56)mmHg] of patients in control group were higher than those ofthe study group, but the eligible rate of blood pressure was lower than that of the study group, showing statistically significant difference(P<0.05); after the intervention, the FPG[(8.31±2.31)mmol/L vs.(7.35±1.01)mmol/L] and HbA1c[(7.59±1.71)% vs.(6.83±1.35)%] of the patients in control group were higher than those of the study group, but the eligible rate of blood glucose was lower than that of the studygroup, showing statistically significant difference (P<0.05); after intervention, the TC[(6.86±1.14)mmol/L vs.(6.27±1.12)mmol/L], TG [(2.96±0.51)mmol/L vs. (2.55±0.39)mmol/L], HDL-C[(1.69±0.33)mmol/L vs. (1.31±0.29)mmol/L], and LDL-C[(3.69±0.71)mmol/L vs. (3.23±0.51)mmol/L] of patients in control group were higher than those in the study group, showing statistically significant difference (P <0.05); After the intervention, the compliance score of patients in study group was higher than that of the control group[(6.87±0.91) vs. (4.41±0.72)], showing statistically significant difference (P<0.05); during the intervention, the cases of adopting the adjusted medication according to pharmacist's recommendations[31(73.81%) vs. 12(28.57%)], and the cases of adopting pharmacist's recommendations [37(90.24%) vs. 14(33.33%)] of the study group were higher than those among patients in control group, showing statistically significant difference (P<0.05).Conclusion Pharmacist intervention measures based on the IMB model is helpful for improving the eligible ratesof blood glucose and blood pressure of patients with T2DM and hypertension after discharging from the hospital, and is helpful for improving the glucose and lipid metabolism conditions of patients, improving their medication compliance, and promoting them to adjusttheir medication plan in time, and actively accept the recommendations from the pharmacists. |
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