| Objective: Through the analysis of the status quo of hypoglycemic drug use in hospitalized patients with type 2 diabetes from 2020 to 2021 and the characteristics of drug use with other complications,a preliminary investigation was carried out,and according to the "China Guidelines for the Prevention and Treatment of Type 2Diabetes"(2020 edition),the Whether the commonly used drugs for diabetes are consistent with the guideline recommendations is summarized and analyzed,and explore the possible factors that make up the difference,and to provide policy suggestions and management strategies for further improving the rational application of diabetes treatment drugs and the supervision and management of relevant departments in the future.On the other hand,by participating in the clinical pharmacy practice of diabetic patients,the author made ward rounds and analysis on the medication and complications of type 2 diabetic patients,analyzes the influencing factors,and provides individualized and targeted guidance for drug services.To evaluate the effect of pharmacy management service,as a strong provide reference for clinical treatment and standardization of pharmacy service work for clinical pharmacists,so as to adapt to the development of clinical pharmacy under the new situation.Methods:(1)300 hospitalized patients with type 2 diabetes from 2020 to2021 were selected from HIS system of our hospital as the research object,and a preliminary investigation was carried out on the use of hypoglycemic drugs and the existing problems and the characteristics of drug use with other chronic complications.According to The Guidelines for The Prevention and Treatment of Type2 Diabetes in China(2020 edition),summarizes and analyzes whether the commonly used hypoglycemic drugs are consistent with the guideline recommendations,puts forward improvement suggestions for unreasonable phenomena,it provides basis for further research on targeted individual pharmaceutical intervention.(2)A total of 200 patients with type 2 diabetes WHO were received to inpatient department of endocrinology from January 2021 to December 2021 were selected as follow-up subjects.All of them had been diagnosed with type 2 diabetes according to WHO standards.They were randomly divided into 2 groups in light of the principle of 1:1,100 objects in each group,and the matched group was took over traditional medical services.The treatment group received pharmaceutical care on the basis of the control group.The two groups of observation indicators were entered into SPSS26.0for Windows 10.0 statistical software for analysis and verification of measurement data and enumeration data,and the blood glucose control,medication deviation,adverse reactions,satisfaction and improvement of life quality were made comparison between the two groups.Results:(1)Among 300 study object with type 2 diabetes,38(12.67%)had no complications,and the highest complications were diabetic peripheral neuropathy(173,57.67%),hypertension(149,49.67%)and Cerebral infarction(129 cases,43.00%);followed by hyperlipidemia(116 cases,38.67%),ocular lesions(74 cases,24.67%),diabetic nephropathy(27 cases,9.00%),ketosis(6cases,2.00%),coronary heart disease(5 cases,1.67%),etc.There were 262(87.33%)patients with complications,with 1-8 complications,including 195 patients with 2-4complications,accounting for 65.00%;According to chi-square test,the occurrence of peripheral neuropathy,hypertension,cerebral infarction,hyperlipidemia,macular degeneration and nephropathy were all correlated with the course of disease,and the longer the course of disease,the higher the complication rate was,showing a positive correlation.Ketosis and coronary heart disease have no significant correlation with the course of disease.(2)The hypoglycemic drugs of 300 patients with type 2diabetes in our hospital were mainly classified into 5 categories,among which metformin,gliclazide,glimepirea,acarbose,repaglinide and nateglinide were the main drugs.Insulin varieties are mainly short-acting,medium-acting and premixed,while other drugs are used but seldom seen.Among the 300 patients,there were 1.68 types of medication per capita,and insulin was the most used,with a total of 232 cases,accounting for 77.33%;followed by biguanides in 99 cases,accounting for33.00%;sulfonylureas in 47 cases,accounting for 15.67% 40 cases of α-glucosidase inhibitors,accounting for 13.33%;40 cases of Glenn nye class,accounting for13.33%.The comparative study found that drug treatment and insulin treatment had nothing to do with the course of the disease,and insulin treatment accounted for the highest proportion.After chi-square check,there is a positive relationship between treatment plan and course of disease,P < 0.05,so there is a difference between them.(3)Among the 300 patients,72(24.00%)were satisfied with fasting blood glucose,58(19.33%)with postprandial blood glucose and 38(12.67%)with Hb Alc.After multivariate Logistic regression analysis,the application of insulin and biguanide drugs had a significant impact on the blood sugar target;the other indicators had no effect.At the same time,the combination medication had a significant impact on the compliance rate of patients’ hemoglobin level,among which,the compliance rate of two-drug combination was the highest,while that of three-drug combination or above was low.Chi-square test proved the discrepancy does not exist between them(P<0.05).(4)They don’t exist statistical difference in the average effective rate of drug therapy between the two groups before intervention(P > 0.05).Therapeutic response rate of the treatment group was obviously improved and clearly better than that of the matched group under each treatment plan after intervention,and there were obvious statistical differences between them(P<0.05).(5)Between the two groups before intervention,they don’t exist significant difference in the mean levels of fasting blood glucose,2h postprandial blood glucose and Hb Alc(P > 0.05).After intervention,the average levels of fasting blood glucose,2h postprandial blood glucose and glycosylated glucose protein in the observation group were lower than those in the control group(P < 0.05).The average quality of life score of the observation group was significantly higher than that of the control group,with statistically significant difference(P < 0.05).(6)The rates of lifestyle,medication behavior,self-monitoring,adverse reactions and related knowledge awareness in the observation group were 93.0%,96.0%,95.0%,91.0%,respectively,which were significantly higher than those in the control group(72.0%,75.0%,71.0%,68.0%,P <0.05).The overall medication compliance rate of the observation group was 96.0%,while that of the control group was 77.0%,obviously,the observation group was significantly higher than the control group(P < 0.05).(7)The overall incidence of adverse reactions in the observation group was 2.0%,and the medication deviation rate was 3.0%,lower than 12.0% and 15.0% in the control group.The overall satisfaction of the observation group was 97.0%,which was obviously higher than that of the control group(82.0%,P < 0.05),indicating a significant difference between them.Conclusions:(1)Inpatients with type 2 diabetes had poor glycemic and Hb Alc control.(2)The prescription of hypoglycemic drugs is unreasonable,and the usage rate of insulin is high.(3)Clinical pharmacists to provide quality specification in patients with type 2 diabetes one-on-one pharmaceutical care,in the ascension of patients medication compliance and blood sugar control target is of great importance to patients.To some extent,it can correct patients’ wrong medication habits and reduce side effects caused by drugs,improve the satisfaction of patients with diagnosis and treatment process,to promote rational drug use of patients. |
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