基于“互联网+”探索针对2型糖尿病出院患者的创新型药学随访服务模式

Research on an Innovative Service Model of Pharmaceutical Follow-up for Type 2 Diabetic Discharge Patient Using “Internet Plus”

关键词:  互联网+  2型糖尿病出院患者  药学随访  临床药师  APP互联软件

Key words:  internet plus  type 2 diabetic discharge patient  pharmaceutical follow-up  clinical pharmacists  APP interconnection software

摘要:

目的 利用“互联网+”技术手段，探索针对2型糖尿病出院患者的创新型药学随访服务模式。方法 选取2019年1月—2019年4月于宁波市中医院内分泌科住院治疗好转后出院的2型糖尿病患者，开展“互联网+”药学随访3个月，通过比较患者随访前后的用药依从性Morisky问卷评分、2型糖尿病患者自我管理能力评分以及糖尿病综合控制指标，评估“互联网+”药学随访的干预效果。结果 药学随访3个月后，2型糖尿病出院患者用药依从性得分从1.94±1.32下降至1.09±0.95（P<0.05），自我管理能力评分由61.91±19.36提高到79.12±13.62（P<0.05）；糖化血红蛋白水平由（9.49±2.31）%下降至（6.69±1.49）%（P<0.05），低密度脂蛋白胆固醇由（2.65±0.95）mmol·L^-1下降至（2.22±0.71）mmol·L^-1（P<0.05），空腹血糖随访前后分别为（6.72±1.38）mmol·L^-1、（6.79±1.07）mmol·L^-1，无显著性差异，基础血糖保持良好。结论 “互联网+”药学随访模式，能显著提高2型糖尿病出院患者的用药依从性、自我管理能力以及糖尿病综合控制指标达标情况，拓展了医疗机构临床药师的药学服务空间，值得在临床实践中进一步完善推广。

Abstract:

OBJECTIVE To explore an innovative service model of pharmaceutical follow-up for type 2 diabetic discharge patient using "Internet plus" technology. METHODS Type 2 diabetes discharge patients who were improved by active treatment in endocrinology department of Ningbo Municipal Hospital of Traditional Chinese Medicine had been selected from January 2019 to April 2019, treated with "Internet plus" pharmaceutical follow-up for 3 months. Scores of medication compliance Morisky questionnaire, self-management ability questionnaire of type 2 diabetic discharge patient and changes of comprehensive control index were compared before and after follow-up to evaluate pharmaceutical service effect. RESULTS Followed up for 3 months, the score of "medication compliance" in type 2 diabetic discharge patient went from 1.94±1.32 to 1.09±0.95(P<0.05), and the score of self-management ability questionnaire had improved from 61.91±19.36 to 79.12±13.62(P<0.05). The level of glycated hemoglobin had decreased from (9.49±2.31)% to (6.69±1.49)% (P<0.05); and low density lipoprotein cholesterol had decreased from (2.65±0.95)mmol·L^-1 to (2.22±0.71)mmol·L^-1 (P<0.05). Fasting blood glucose was (6.72±1.38)mmol·L^-1 and (6.79±1.07)mmol·L^-1 before and after follow-up, and there was no significantly difference between them. Baseline fasting glucose leve had been kept on an even keel. CONCLUSION The innovative service model of pharmaceutical follow-up using "Internet plus" technology have significantly improved the medication compliance, self-management ability and diabetes comprehensive control index, expanding the space of pharmaceutical care for clinical pharmacists in medical institutions. "Internet plus" innovative service model of pharmaceutical follow-up is worthy of being generalized in clinical practice.