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首页> 外文期刊>Journal of the American Pharmacists Association: JAPhA >Patient self-management program for diabetes: first-year clinical, humanistic, and economic outcomes.
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Patient self-management program for diabetes: first-year clinical, humanistic, and economic outcomes.

机译：糖尿病患者自我管理计划：第一年的临床，人文和经济成果。

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OBJECTIVE: To assess the outcomes for the first year following the initiation of a multisite community pharmacy care services (PCS) program for patients with diabetes. DESIGN: Quasi-experimental, pre-post cohort study. SETTING: 80 community pharmacy providers with diabetes certificate program training who were reimbursed for PCS by employers in Greensboro, N.C., Wilson, N.C., Dublin, Ga., Manitowoc County, Wis., and Columbus, Ohio. PATIENTS: 256 patients with diabetes covered by self-insured employers' health plans. INTERVENTIONS: Community pharmacist patient care services using scheduled consultations, clinical goal setting, monitoring, and collaborative drug therapy management with physicians and referrals to diabetes educators. MAIN OUTCOME MEASURES: Changes in glycosylated hemoglobin (AIC), low-density lipoprotein cholesterol (LDL-C), blood pressure, influenza vaccinations, foot examinations, eye examinations, patient goals for nutrition, exercise, and weight, patient satisfaction, and changes medical and medication utilization and costs. RESULTS: Over the initial year of the program, participants' mean A1C decreased from 7.9% at initial visit to 7.1%, mean LDL-C decreased from 113.4 mg/dL to 104.5 mg/dL, and mean systolic blood pressured decreased from 136.2 mm Hg to 131.4 mm Hg. During this time, influenza vaccination rate increased from 52% to 77%, the eye examination rate increased from 46% to 82%, and the foot examination rate increased from 38% to 80%. Patient satisfaction with overall diabetes care improved from 57% of responses in the highest range at baseline to 87% at this level after 6 months, and 95.7% of patients reported being very satisfied or satisfied with the diabetes care provided by their pharmacists. Total mean health care costs per patient were Dollars 918 lower than projections for the initial year of enrollment. CONCLUSION: Patients who participated in the program had significant improvement in clinical indicators of diabetes management, higher rates of self-management goal setting and achievement, and increased satisfaction with diabetes care, and employers experienced a decline in mean projected total direct medical costs.
机译：目的：评估针对糖尿病患者的多站点社区药房服务（PCS）计划启动后第一年的结果。设计：准实验的队列前研究。地点：北卡罗来纳州格林斯博罗，北卡罗来纳州威尔逊，北卡罗来纳州都柏林，威斯康星州马尼托沃克县和俄亥俄州哥伦布的雇主为80位接受糖尿病证书计划培训的社区药房提供者报销PCS。患者：256名糖尿病患者接受了自保雇主的健康计划。干预措施：使用预定的咨询，临床目标设定，监测以及与医生的合作药物治疗管理以及转介给糖尿病教育者的社区药剂师患者护理服务。主要观察指标：糖基化血红蛋白（AIC），低密度脂蛋白胆固醇（LDL-C），血压，流感疫苗接种，足部检查，眼睛检查，患者营养，运动和体重目标，患者满意度和变化的变化医疗和药物利用率和费用。结果：在该计划的最初一年中，参与者的平均A1C从初次就诊时的7.9％降至7.1％，平均LDL-C从113.4 mg / dL降至104.5 mg / dL，平均收缩压从136.2 mm降低汞柱至131.4毫米汞柱。在此期间，流感疫苗接种率从52％增加到77％，眼睛检查率从46％增加到82％，足部检查率从38％增加到80％。六个月后，患者对总体糖尿病护理的满意度从基线最高范围的响应的57％提高到此水平的87％，并且95.7％的患者报告对他们的药剂师提供的糖尿病护理非常满意或满意。每个患者的平均平均医疗保健费用比入学第一年的预测低918美元。结论：参加该计划的患者在糖尿病管理的临床指标方面有显着改善，自我管理目标设定和成就的发生率更高，对糖尿病护理的满意度更高，而且雇主的平均预计直接医疗总费用有所下降。

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