| Objective(s):1.Through the investigation of type 2 diabetes patients treated in the Metabolic Management Center of a grade A tertiary hospital in Yunnan province,to understand the current status of medication adherence and self-management behavior of patients with type 2 diabetes,and explore the influencing factors of medication adherence and self-management ability of patients with type 2 diabetes,to providing reference for pharmacists to develop corresponding pharmaceutical care measures and participate in medication management of patients with type 2 diabetes.2.Pharmaceutical intervention was performed on type 2 diabetes patients enrolled in the Metabolic Management Center to study the influence of pharmaceutical intervention on medication adherence,self-management,quality of life,blood glucose control,etc.Methods:1.With the questionnaire survey method,420 patients with type 2 diabetes were investigated in the Metabolic Management Center of a grade A tertiary hospital in Yunnan Province,The research tools mainly included Medication information questionnaire,Morisky Medication Adherence Scale,The Summary of Diabetes Self-care Activities measure,etc.2.Based on the randomized controlled design,80 patients with type 2 diabetes who met the inclusion and exclusion criteria in the Metabolic Management Center of a grade A tertiary hospital in Yunnan province were included and randomly divided into the experimental group and the control group with 40 patients in each group.The control group was followed up with routine MMC,and the experimental group was supplemented with pharmaceutical care.Medication adherence,self-management ability,quality of life,fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin values of the two groups were collected before and after intervention by Morisky Medication Adherence Scale,The Summary of Diabetes Self-care Activities measure,Diabetes Specific Quality of Life scale and General data questionnaire.Results:1.A total of 420 questionnaires were sent out,of which 415 were valid,with effective recovery rate of 98.81%.The medication adherence rate of type 2 diabetes patients was 58.80%,and occupation,family history,course of disease,medication type and adverse reactions were independent influencing factors of medication adherence(P < 0.05).The mean score of self-management ability was(42.27±10.98)points,which was at the medium level.Medical security,working conditions,smoking and disease course were independent factors affecting self-management ability(P < 0.05).Medication adherence score was negatively correlated with glycosylated hemoglobin(r =-0.304,P < 0.001).The score of self-management ability was negatively correlated with glycosylated hemoglobin(r =-0.378,P <0.001).2.There was no significant difference in baseline general data between the control group and the experimental group(P > 0.05);Before intervention,the medication adherence rates of control group and experimental group were 71.40% and 66.70%,respectively,and there was no statistical significance between the two groups(P >0.05).After intervention,the medication adherence rates of control group and experimental group were 77.20% and 97.20%,respectively,and the difference between the two groups was statistically significant(P < 0.05).Before intervention,the scores of self-management ability of control group and test group were(44.69±11.29)points and(44.86±10.19)points,respectively,and there was no significant difference between the two groups(P > 0.05).After intervention,the scores of self-management ability of control group and experimental group were(49.80±8.91)points and(56.75±6.40)points,respectively,and the difference between the two groups was statistically significant(P < 0.05).Before intervention,the quality of life scores of control group and experimental group were(59.69±12.34)points and(61.81±10.84)points,respectively,and there was no significant difference between the two groups(P > 0.05).After intervention,the quality of life scores of the control group and the experimental group were(53.63±8.15)points and(45.69±4.96)points,respectively,and the difference between the two groups was statistically significant(P< 0.05).Before intervention,the fasting blood glucose of the control group and the experimental group were(8.47±2.17)mmol/L and(8.38±1.98)mmol/L,respectively,and there was no statistical significance between the two groups(P > 0.05).After intervention,the fasting blood glucose of the control group and the experimental group were(6.97±1.24)mmol/L and(6.12±1.01)mmol/L,respectively,and the difference between the two groups was statistically significant(P < 0.05).Before intervention,the 2-hour postprandial blood glucose of control group and experimental group were(11.62±3.52)mmol/L and(11.53±3.29),respectively,and there was no statistical significance between groups(P > 0.05).After intervention,the2-hour postprandial blood glucose of the control group and the experimental group were(9.27±1.47)mmol/L and(8.36±1.47)mmol/L,respectively,and the difference between the two groups was statistically significant(P < 0.05).Before intervention,the HBA1 c values of control group and experimental group were(8.43±1.81)% and(8.49±2.07)%,respectively,and there was no statistical significance between the two groups(P > 0.05).After intervention,the HBA1 c values of control group and experimental group were(7.23±1.10)% and(6.63±0.99)%,respectively,and the difference between groups was statistically significant(P < 0.05).Conclusion(s):1.In this study,medicationadherence and self-management ability of patients with type 2 diabetes were generally at a low to medium level,which was closely related to blood sugar control.Occupation,family history,course of disease,type of medication and adverse reactions were the main influencing factors of medication adherence,while medical security,working status,smoking and course of disease were the main influencing factors of self-management ability.When pharmacists carried out pharmaceutical care work,corresponding strategies and targeted intervention measures could be formulated according to the main influencing factors.2.Pharmacists’ participation in MMC management of diabetic patients can better improve medication adherence,self-management ability,quality of life and blood sugar control of patients with type 2 diabetes. |
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