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首页> 外文期刊>The International journal of pharmacy practice >Effectiveness and acceptability of community pharmacy-based interventions in type 2 diabetes:a critical review of intervention design, pharmacist and patient perspectives
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Effectiveness and acceptability of community pharmacy-based interventions in type 2 diabetes:a critical review of intervention design, pharmacist and patient perspectives

机译：基于社区药房干预的2型糖尿病的有效性和可接受性：对干预设计，药剂师和患者观点的严格审查

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Objective It is generally accepted that greater use could be made of community pharmacy-based interventions. Diabetes care has been proposed as an area for enhanced community pharmacy involvement. However there is no published structured review of available evidence of either effectiveness or acceptability. This review aims to identify and assess such evidence and to synthesise findings to inform the design and delivery of future community pharmacy-based interventions in diabetes care.Method A systematic search of published literature was conducted using a defined search strategy, electronic databases and targeted hand searching of non Index Medicus journals. The search dates were 1990-2003. The scope was international and we included only articles in the English language. Key findings Seven experimental studies which tested community pharmacy-based interventions were reviewed. Four different primary outcomes were studied: diabetes control (three studies), adherence (two studies), medication problems (one study) and patient knowledge (one study). Six studies showed positive outcomes, and the findings were statistically significant in two. The theoretical basis of the interventions was unclear. Only one study included a cost-effectiveness analysis, and the interventions were provided free of charge to patients in all seven studies. Nine attitudinal studies were included, five involving pharmacists and four with patients. Members of the public do not currently expect community pharmacists to become involved in discussions about diabetes treatment and its monitoring, but when such services are offered they are well used by patients. Pharmacists were positive about the provision of services for people with diabetes. Patients' experiences indicated that community pharmacists overestimate their current provision of information and advice to people with diabetes.Conclusions There is limited evidence of effectiveness of community pharmacy-based interventions in diabetes care. Components of pharmacy-based intervention which appear to contribute to effectiveness include: elicitation and discussion of patient beliefs about their diabetes and its treatment; discussion of how patients are using their medicines; review of haemoglobin A_(1c) (HbA_(1c)) levels; and assessing and supporting necessary lifestyle changes. Further research is needed and future interventions need to incorporate evidence from the literature on patient and pharmacist perspectives on diabetes. The findings of this review will be useful to researchers and service planners involved in developing community pharmacy-based diabetes care.
机译：目的普遍认为，可以更多地使用基于社区药房的干预措施。已经提出糖尿病护理作为增加社区药房参与的领域。但是，对于有效或可接受性的可用证据，没有公开的结构化审查。这篇综述旨在鉴定和评估此类证据，并综合研究结果，以设计和交付未来基于社区药房的糖尿病护理干预方法。方法使用已定义的搜索策略，电子数据库和针对性的手对出版的文献进行系统的搜索搜索非Index Medicus期刊。搜索日期是1990-2003。范围是国际性的，我们只收录了英文文章。主要发现综述了七项试验研究，这些试验研究了基于社区药学的干预措施。研究了四种不同的主要结局：糖尿病控制（三项研究），依从性（两项研究），用药问题（一项研究）和患者知识（一项研究）。六项研究显示出积极的结果，其中两项发现具有统计学意义。干预的理论基础尚不清楚。只有一项研究包括成本-效果分析，所有七项研究均免费向患者提供干预措施。包括九项态度研究，其中五项涉及药剂师，四项针对患者。公众目前不期望社区药剂师参与有关糖尿病治疗及其监测的讨论，但是当提供此类服务时，患者会很好地利用它们。药剂师对为糖尿病患者提供服务持肯定态度。患者的经验表明，社区药师高估了他们目前向糖尿病患者提供的信息和建议。结论仅有很少的证据表明以社区药房为基础的干预措施在糖尿病护理中的有效性。基于药物的干预措施似乎有助于提高疗效，其中包括：引发和讨论患者对糖尿病及其治疗的看法;讨论患者如何使用药物;审查血红蛋白A_（1c）（HbA_（1c））水平;并评估和支持必要的生活方式改变。需要进一步的研究，未来的干预措施还需要结合患者和药剂师关于糖尿病的文献资料。此次审查的结果对参与开发基于社区药房的糖尿病护理的研究人员和服务计划人员很有用。

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