基于IMB模型的药师干预对2型糖尿病合并超质量患者依从性的影响  

Effects of IMB-model-based pharmacist intervention on the compliance and clinical effect on type 2 diabetes with overweight/obesity

作　　者：汤涛 郑欢欢 王玉兰[1] 计成[2] 李友佳[3] TANG Tao;ZHENG Huanhuan;WANG Yulan;JI Cheng;LI Youjia(Ji’an Central People’s Hospital,Ji’an 343000,China;Department of Pharmacy,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Pharmacy,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]吉安市中心人民医院,吉安343000 [2]南京大学医学院附属鼓楼医院药学部,南京210008 [3]西安交通大学第二附属医院药学部,西安710004

出　　处：《西北药学杂志》2024年第4期213-219,共7页Northwest Pharmaceutical Journal

基　　金：吉安市指导性科技计划项目(编号:20222-026680)。

摘　　要：目的探讨采用信息-动机-行为技巧(information-motivation-behavioral,IMB)模型的药学干预措施对2型糖尿病(type 2 diabetes mellitus,T2DM)合并超质量/肥胖患者的用药依从性及临床效果的影响。方法将内分泌科就诊的T2DM合并超质量/肥胖患者作为研究对象,采用单因素和多因素分析方法评估影响用药依从性的因素;按照随机数字表法分为对照组和试验组,对照组采用传统的药学干预方法,试验组采用基于IMB模型的药学干预措施,干预时间为12个月。比较干预前后体质量、腰围、用药依从性、糖化血红蛋白、血压(收缩压、舒张压)、血脂(总胆固醇、三酰甘油、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇)水平,评估干预效果。结果共纳入96例T2DM合并超质量/肥胖患者,用药依从性较好患者的占比为46.88%,文化程度、家庭平均月收入以及复诊频次与患者的依从性成正比。基于IMB模型的药学干预12个月后,试验组患者的体质量、腰围、用药依从性量表评分、血压、糖化血红蛋白及血脂控制情况较对照组均显著提高(P<0.05)。结论基于IMB模型的药学干预有助于改善T2DM合并超质量/肥胖患者的体质量、腰围、血糖、血压和血脂达标情况,提高患者的用药依从性。Objective To study the effects of pharmacist interventions dominated by information-motivation-behavioral(IMB)model on the compliance and clinical effect in patients suffering from type 2 diabetes(T2DM)with overweight/obesity.Methods T2DM patients with concurrent overweight/obesity who seek treatment in the endocrinology department were enrolled as the research subjects.Single factor analysis and multivariate analysis were used to assess the factors affecting the compliance.The patients were divided into a test group and a control group randomly.The control group was treated with normal procedure.In addition to the routine treatment,the test group was treated with pharmacist intervention measures based on IMB model for 12 months.The indicators of weight,waist circumference(WC),medication compliance,glycosylated hemoglobin(HbA1c),systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-CH)and low density lipoprotein cholesterol(LDL-CH)in the 2 groups were compared before and after the intervention.Results Totally 96 patients with T2DM with overweight/obesity were included.Patients with good medication compliance reached up to 46.88%.The education level,average monthly family income and frequency of follow-up visits were positively correlated with the patient compliance.After 12 months of pharmacist intervention,the weight,WC,the score of medication compliance scale,the SBP,DBP,HbA1c and blood lipid of patients in the test group were significantly higher than those in the control group(P<0.05).Conclusion Pharmacist intervention measures based on the IMB model is helpful to improve the weight,WC,blood glucose,blood pressure and blood lipid compliance of T2DM with overweight/obesity,and improve the medication compliance of patients.

关 键 词：信息-动机-行为技巧模型 药师干预 2型糖尿病 肥胖 依从性 

分 类 号：R95[医药卫生—药学]