外来糖尿病患者に対する「薬剤師外来」の成果

抄録

Pharmaceutical care clinics, wherein hospital pharmacists intervene to resolve the issues of outpatients, have been established in many hospitals in Japan. The purpose of this study was to verify the usefulness of pharmaceutical care clinics in the treatment of diabetes. Between April 2014 - March 2016, among type 2 diabetic outpatients who received pharmaceutical care, 34 patients who had a glycated hemoglobin (HbA1c) value ≥7.5％ were included in the pharmacist intervention group and 45 patients who had been consulted only by a nurse or a nutritionist were included in the pharmacist non-intervention group. HbA1c was determined and compared for 9 months among the two patient groups. Although a decrease in HbA1c value was observed in the pharmacist non-intervention group, HbA1c increased gradually from 6 months onwards. After 9 months, a significant difference in HbA1c was found between the pharmacist intervention and non-intervention groups (P = 0.047). With the intervention of nurses and nutritionists alone, it was impossible to suppress the rise in HbA1c value in type 2 diabetic outpatients continuously for 9 months. In the pharmacist intervention group, patients with poor glycemic control and problems of adherence were extracted and instructed more firmly. Because pharmacists spent adequate time identifying patients and improving medication adherence and lifestyle, favorable glycemic control could be achieved for the long term. Therefore, hospital pharmacists play an important role in providing appropriate medication for outpatients.