| Objective: From an investigation on the medication status of patients with type 2 diabetes including the types and treatment regimens of hypoglycemic agents,and an analysis on the factors that affect the blood glucose control in a grassroots tertiary hospital,this research paper provides pharmaceutical intervention on the use of glucose-lowering drug according to the influence factors and evaluates the effect of integrated pharmaceutical intervention.Therefore,the results may provide the useful reference for the rational use of drugs in patients with type 2 diabetes.Methods:1?Through the medical and pharmaceutical ward round,questionnaires and the hospital information management system(HIS),collected the type 2diabetes hospitalized patients from endocrinology department of the grassroots tertiary hospital in October 2015 to March 2016.Evaluated the medication status of patients with type 2 diabetes in the hospital and analyzed the factors that affect the blood glucose control after data statistics.2?Designed a randomized and a controlled experiment,152 applicable patients with type 2 diabetes from endocrinology department of the grassroots tertiary hospital during April to September in 2016 were divided into two groups.One is intervention group including 75 cases and the rest is in the control group with 77 cases.In addition to medical services,the intervention group was accepted both pharmaceutical care and conventional medical,while the control group received conventional medical only.Through astatistical analysis which includes blood glucose levels,compliance rate of glycosylated hemoglobin(HbAlc),self-management behavior,medication deviation,adverse drug reaction(ADR)and satisfaction between intervention group and control group,evaluated the effect of pharmaceutical intervention.Results:1 ? The investigation shows that the fasting plasma glucose(FPG),2h-postprandial glucose(2h-PG)and HbAlc rates were 21.38%,17.11% and12.58% in the 795 cases of patients with type 2 diabetes who were investigated.The multi-factor logistic regression analysis shows that insulin is the protective factor of FPG and 2h-PG,while insulin and metformin are protective factors of HbAlc.The most frequently used were insulin(85.28%),biguanides(27.30%)and sulfonylureas(15.97%)in patients with type 2diabetes at the Grassroots areas.No mater single or combined drug treatment,insulin is the most widely used.The overall incidence of ADR in all patients was 35.97% and hypoglycemia(22.26%)occupied the highest frequency.With the increasing of drug numbers,the incidence of ADR also increased.Overall self-management behavior compliance of the patients was 40.63%.Compliance rate of HbAlc of the patients in poor self-management behavior was only 8.05%,compared with the compliance rate of HbAlc in good self-management behavior patients 19.20%.2?Compared with the control group,the mean FPG,2h-PG and HbAlc reduced significantly(P<0.05)in intervention group and the compliance rates were much higher(P<0.05).After accepted pharmaceutical care,the mean FPG,2h-PG and HbAlc of intervention group reduced significantly also(P<0.05)and the compliance rates of FPG and Hb Alc were even higher(P<0.05).In the intervention group,the self-management behavior compliance increased significantly(P<0.05)and the rate of medication deviation,as well as the incidence of ADR decreased significantly(P<0.05).The satisfaction of medical service was higher than the control group(P<0.05).Conclusion: The patients with type 2 diabetes in grassroots areas are unsatisfactory in blood glucose control,but the hypoglycemic drug distribution and drug treatment program are reasonable.The most common used treatment is insulin.Comprehensive pharmaceutical intervention mode for doctors,nurses and patients can not only improve the level of drug treatment for clinicians,but also regulate the medication behavior of nursing staff.This measurement could reduce the blood glucose level in patients with type 2 diabetes and ensure the safety and rationality of drug use,lower the incidence possibility of ADR,also improve the compliance rate of blood glucose.Therefore,this mode of pharmaceutical intervention has great clinical significance.Clinical pharmacists play a positive role in promoting the rational use of drugs in patients with type 2 diabetes. |
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