| 摘要: | 飲食管理、規律運動及藥物治療之介入計劃，已被證明是一種可以有效治療及預防第2型糖尿病併發症的策略。需要長期控制血糖，但病患的依順性或服藥順從性往往是一個影響血糖控制不佳的重要因素。通常，糖尿病患者每三個月才會到醫院回診接受衛教，但每個月糖尿病患者都會到社區藥局領取慢性處方籤藥物，可接受社區健保藥局藥師衛教介入的頻率較多。因此本研究欲探討社區健保藥局藥師介入糖尿病患者的治療照護，是否能有效改善病患的服藥順從性，進而改善血糖的控制。本研究收集50位持有慢性處方籤到社區健保藥局領藥的第2型糖尿病個案，先進行問卷的前測，同時收集紀錄血糖、血壓、體重、糖化血色素等相關數據，之後對患者進行衛教，4個月後進行問卷的後測及相關數據收集，以分析比較經藥師衛教介入後的變化。從問卷內容統計結果顯示經過藥師4次的衛教後，個案在糖尿病用藥知識、生活型態及對第2型糖尿病的認知、以及對社區健保藥局藥師的認知方面均有所改善(p<0.05)。而個案在飲食管理、規律運動及藥物順從性的改善，也反應在血糖的控制上。藥師衛教前，個案空腹血糖值平均為140±30.8mg/dl，衛教後平均為110±18.2mg/dl；衛教前的飯後血糖值平均為260±44.1mg/dl，衛教後平均為158±20.8mg/dl；衛教前的糖化血色素值平均為8.25±0.9%，衛教後平均為7.5±0.6 %，三者在藥師衛教前後，均具有統計學上明顯的差異(p<0.05)。由此研究結果可知社區健保藥局藥師較頻繁的介入，可衛教第2型糖尿病患者飲食管理、規律運動及藥物順從性的重要，不僅可控制血糖穩定，提升生活品質，也可減少不必要的醫療資源浪費。
The intervention program of diet management, regular exercise and drugs therapy has proven to be an effective treatment and prevention strategies for type 2 diabetes and its complications. However, adherence or compliance is often an important factor in the poor glycemic control. Typically every three months, diabetes patients will be back to the clinic hospital for health care. But every month, diabetes patients with chronic prescription will receive the intervention of health education from community pharmacy pharmacists more frequency. Therefore, this study wound to investigate the community pharmacy pharmacists involved in the health care of diabetes patients, whether it can effectively improve medication compliance, thereby improving glycemic control. This study collected 50 type 2 diabetes cases, the pre-test questionnaire, as well as blood glucose, blood pressure, weight, glycated hemoglobin, were collected and recorded. After the intervention of health education, post-test questionnaire and the other data were collected four months later, in order to analyze the changes. Statistics from the questionnaire showed that after 4 times pharmacist health education, most cases in “diabetes medication knowledge”, “lifestyle and awareness of type 2 diabetes”, as well as “awareness of the community pharmacy pharmacists aspects” were improved (p < 0.05). The good compliance of diet management, regular exercise, and take drugs also reflected in the control of blood sugar. The averaged fasting blood glucose values were 140±30.8 mg/dl before pharmacist health education, and 110±18.2 mg/dl after health education; averaged postprandial blood glucose values were 260±44.1 mg/dl and 158±20.8 mg/dl; averaged glycated hemoglobin value were 8.25±0.9% and 7.5±0.6%, respectively. All have statistically significant difference in pharmacists health education for type 2 diabetes patients (p <0.05). Thus, the results show that the pharmacists of community pharmacy more frequent intervention of health education, may improve the dietary management, regular exercise and medication compliance of type 2 diabetes patients. And type 2 diabetes patients with stable blood sugar control not only enhanced the quality of life, but also reduced unnecessary medical consume of resources. |
