Objective  To investigate the medication and blood glucose control of type 2 diabetes patients under chronic diseases management in Xi’an chain pharmacies, and provides reference for improving the management policy of diabetes at grassroots level.

Methods  A number of chain pharmacies in the sixth district of Xi’an were selected by random sampling method, and on-site interviews were conducted by questionnaire survey to patients with type 2 diabetes under the management of chronic diseases. The basic information of patients, medication status (medication plan, drug adherence, etc.), diabetes-related conditions (blood glucose status, family history, course and complications, etc.) were collected. Multivariate logistic regression was used to analyze the relevant factors of blood glucose control in patients.

Results  A total of 403 patients were surveyed, the largest number of patients use oral hypoglycemic drugs alone (53.4%), followed by insulin medication (including insulin only and insulin in combination with oral hypoglycemic drugs) (35.7%), and the differences between disease course and glycemic control among patients with different drug regimens were statistically significant (P<0.05). Only 43.7% of patients had good medication compliance. In addition, the patient’s fast plasma glucose compliance rate was only 39.2%. The results of multivariate logistic regression analysis showed that good medication compliance (OR=1.744, 95%CI 1.104 to 2.754, P=0.017) were independent influencing factors for achieving glycemic control.

Conclusion  The medication compliance of type 2 diabetes patients with poor blood glucose control in chronic disease management of chain pharmacies in Xi’an needs to be strengthened. Pharmacies should emphasize and give full play to the professional and service advantages of pharmacists to realize the functional role of pharmacies and strengthen diabetes management.

1.Xu Y, Wang L, He J, et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA, 2013, 310(9): 948-959. DOI: 10.1001/jama.2013.168118.

2.International Diabetes Federation. IDF Diabetes Atlas 10th edition[R]. 2021.

3.International Diabetes Federation. IDF Diabetes Atlas 6th edition[R]. 2013.

4.Glovaci D, Fan W, Wong ND. Epidemiology of diabetes mellitus and cardiovascular disease[J]. Curr Cardiol Rep, 2019, 21(4): 21. DOI: 10.1007/s11886-019-1107-y.

5.区政强. 慢性病管理是零售药店发展的重点方向 [J]. 上海医药, 2017, 38(7): 60-64. [Ou ZQ. Chronic disease management is a key direction of retail pharmacy development[J]. Shanghai Medical & Pharmaceutical Journal, 2017, 38(7): 60-64.] DOI: 10.3969/j.issn.1006- 1533.2017.07.024.

6.田跃清. 以顾客为核心，构建慢病管理服务体系[J]. 中国药店, 2021, 21(8): 66-67. [Tian YQ. Take customers as the core and build a chronic disease management service system[J]. China Drug Store, 2021, 21(8): 66-67.] http://qikan.cqvip.com/Qikan/Article/Detail?id=7105525162.

7.王静, 张臣宇, 吴迪, 等. 成都市社会药房慢病管理服务现状调查研究[J]. 中国药房, 2020, 31(5): 622-626. [Wang J, Zhang CY, Wu D, et al. Investigation and study on the current situation of chronic disease management service in social pharmacy of Chengdu[J]. China Pharmacy, 2020, 31(5): 622-626.] DOI: 10.6039/j.issn.1001- 0408.2020.05.23.

8.金丕焕, 主编. 医用统计方法[M]. 上海: 复旦大学出版社, 2003: 1-600.

9.杨群娣. 上海市社区管理的2型糖尿病患者血糖控制与药物治疗现状[D]. 上海: 复旦大学, 2010. https://d.wanfangdata.com.cn/thesis/ChJUaGVzaXNOZXdTMjAyNDAxMDkSB0QzOTgyNTMaCHVtN2UzbmJ3.

10.Shiu AT, Wong RY, Thompson DR. Development of a reliable and valid Chinese version of the diabetes empowerment scale[J]. Diabetes Care, 2003, 26(10): 2817-2821. DOI: 10.2337/diacare.26.10.2817.

11.吴永泽. 糖尿病患者自我管理KAB评价简化量表的研究[D]. 北京: 中国疾病预防控制中心, 2010. https://xueshu.baidu.com/usercenter/paper/show?paperid=0644a1270f44eea906c6abfacb25d4b4&site=xueshu_se&hitarticle=1.

12.王文绢. 糖尿病患者自我管理量表的研究与应用[J]. 中华预防医学杂志, 2016(1): 4-6. [Wang WJ. Research and application of diabetes self-management scale[J]. Chinese Journal of Preventive Medicine, 2016(1): 4-6.] DOI: 10.3760/cma.j.issn.0253-9624.2016.01.002.

13.中国疾病预防控制中心. 中国成人体重判定[EB/OL]. (2015-01-16) [2023-02-01]. https://www.chinacdc.cn/jkzt/yyhspws/xzdc/201501/t20150116_109920.html.

14.中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版) [J]. 2021, 13(4): 315-409. DOI: 10.3760/cma.j.cn115791-20210221-00095.

15.Athavale AS, Bentley JP, Banahan BF, et al. Development of the medication adherence estimation and differentiation scale (MEDS)[J]. Curr Med Res Opin, 2019, 35(4): 577-585. DOI: 10.1080/03007995.2018.1512478.

16.俞吉, 冉烁, 徐玲. Morisky用药依从性量表8条目在老年慢性病患者用药评价中的应用[J]. 临床药物治疗杂志, 2020, 18(11): 63-66. [Yu J, Ran S, Xu L. Application of 8-item Morisky Medication Adherence Scale in medication evaluation of elderly patients with chronic diseases[J]. Clinical Medication Journal, 2020, 18(11): 63-66.] DOI: 10.3969/j.issn.1672-3384.2020.11.015.

17.李锐, 施亮, 杨群娣, 等. 上海市社区管理2型糖尿病患者血糖控制和用药情况[J]. 环境与职业医学, 2016, 33(4): 329-333. [Li R, Shi L, Yang QD, et al. Glycemic control and medication compliance of type 2 diabetes in community management system in Shanghai[J]. Journal of Environmental & Occupational Medicine, 2016, 33(4): 329-333.] DOI: 10.13213/j.cnki.jeom.2016.15274.

18.Menke A, Rust KF, Fradkin J, et al. Associations between trends in race/ethnicity, aging, and body mass index with diabetes prevalence in the United States: a series of cross-sectional studies[J]. Ann Intern Med, 2014, 161(5): 328-335. DOI: 10.7326/M14-0286.

19.万菁菁, 鲁志兵, 孙家忠. 2型糖尿病肥胖患者心血管危险因素的研究现状[J]. 医学新知杂志, 2019, 29(5): 529-532. [Wan JJ, Lu ZB, Sun JZ. Research status on cardiovascular risk factors in obese patients with type 2 diabetes mellitus[J]. New Medicine, 2019, 29(5): 529-532.] DOI: 10.3969/j.issn.1004-5511.2019.05.019.

20.徐平, 徐勇. 低血糖与心血管事件风险[J]. 实用医院临床杂志, 2012, 9(2): 174-177. [Xu P, Xu Y. Hypoglycemia and the risk of cardiovascular events[J]. Practical Journal of Clinical Medicine, 2012, 9(2): 174-177.] DOI: 10.3969/j.issn.1672-6170.2012.02.064.

21.廖洋洋, 周佩如. 糖尿病病人发生低血糖事件的危险因素及预测模型的研究进展[J]. 循证护理, 2022, 8(4): 474-478. [Liao YY, Zhou PR. Research progress on risk factors and prediction models of hypoglycemic events in diabetic patients[J]. Chinese Evidence-based Nursing, 2022, 8(4): 474-478.] DOI: 10.12102/j.issn.2095-8668. 2022.04.008.

22.田勇. 2型糖尿病患者发生药物性低血糖的影响因素研究[J]. 重庆医学, 2015, 44(27): 3813-3816. [Tian Y. Study on the influencing factors of drug-induced hypoglycemia in patients with type 2 diabetes mellitus[J]. Chongqing Medicine, 2015, 44(27): 3813-3816.] DOI: 10.3969/j.issn.1671-8348.2015.27.022.

23.邹晓莹, 孙中华, 韩晶. 糖尿病患者治疗过程中发生低血糖的原因分析[J]. 中国全科医学, 2012, 15(6): 690-693. [Zou XY, Sun ZH, Han J. Study on the causes of hypoglycemia in patients with diabetes mellitus during therapy[J]. Chinese General Practice, 2012, 15(6): 690-693.] DOI: CNKI:SUN:QKYX.0.2012-06-039.

24.姜云, 陈明军, 王泽茂, 等. 影响慈溪市农村2型糖尿病患者用药依从性的调查分析[J]. 中国乡村医药, 2015, 22(13): 65-66. [Jiang Y, Chen MJ, Wang ZM, et al. Investigation and analysis of medication adherence affecting rural patients with type 2 diabetes mellitus in Cixi City[J]. Chinese Journal of Rural Medicine and Pharmacy, 2015, 22(13): 65-66.] DOI: 10.3969/j.issn.1006-5180. 2015.13.044.

25.孙婧, 毕艳, 胡云, 等. 江苏省2型糖尿病患者血糖控制及治疗用药情况调查[J]. 中国糖尿病杂志, 2011, 19(8): 591-594. [Sun J, Bi Y, Hu Y, et al. Investigation of glycemic control and antidiabetic therapy in type 2 diabetic patients in Jiangsu province[J]. Chinese Journal of Diabetes, 2011, 19(8): 591-594.] DOI: 10.3969/j.issn. 1006-6187.2011.08.010.

26.胡彩红, 张梅, 张笑, 等. 中国35岁及以上糖尿病患者社区管理现状[J]. 中国慢性病预防与控制, 2021, 29(4): 264-267. [Hu CH, Zhang M, Zhang X, et al. The management status of diabetes patients (≥35 years old) in communities of China[J]. Chinese Journal of Prevention and Control of Chronic Diseases, 2021, 29(4): 264-267.] DOI: 10.16386/j.cjpccd.issn.1004-6194.2021.04.006.

27.金丽茵, 吴刚, 龚辉. 社区2型糖尿病患者影响糖化血红蛋白达标率因素分析[J]. 山西医药杂志, 2016, 45(7): 757-759. [Jin LY, Wu G, Gong H. The influencing factors analysis of glycosylated hemoglobin among type 2 diabetic community patients[J]. Shanxi Medical Journal, 2016, 45(7): 757-759.] DOI: 10.3969/j.issn.0253-9926. 2016.07.004.

28.李霞, 白小岗, 刘欣. 老年2型糖尿病患者血糖达标率及影响因素的调查分析[J]. 解放军预防医学杂志, 2017, 35(10): 1242-1245. [Li X, Bai XG, Liu X. Investigation of glucose-target-rate and influencing factors of type 2 diabetes mellitus among elders[J]. Journal of Preventive Medicine of Chinese People's Liberation Army, 2017, 35(10): 1242-1245.] DOI: CNKI:SUN:JYYX.0. 2017-10-020.

29.牛鹏. 血糖控制对2型糖尿病慢性并发症的影响[J]. 医学综述, 2011, 17(13): 2001-2004. [Niu P. Effects of blood glucose control on chronic complications of type 2 diabetes[J]. Medical Recapitulate, 2011, 17(13): 2001-2004.] DOI: 10.3969/j.issn.1006-2084.2011.13.029.

30.Simpson SH, Lin M, Eurich DT. Medication adherence affects risk of new diabetes complications: a cohort study[J]. Ann Pharmacother, 2016, 50(9): 741-746. DOI: 10.1177/1060028016653609.

31.徐红. 山东省社会药房慢性病管理现状调查研究 [J]. 中国现代应用药学, 2023, 40(7): 982-988. [Xu H. Investigation on the current situation of chronic disease management in community pharmacy in Shandong province[J]. Chinese Journal of Modern Applied Pharmacy, 2023, 40(7): 982-988.] DOI: 10.13748/j.cnki.issn1007-7693.20223914.

32.向玉芳, 牛瑞, 苟喜兰, 等. 陕西省糖尿病患者血糖监测及用药情况[J]. 医药导报, 2019, 38(11): 1514-1518. [Xiang YF, Niu R, Gou XL, et al. Blood glucose monitoring and medication analysis of diabetic patients in Shaanxi Province[J]. Herald of Medicine, 2019, 38(11): 1514-1518.] DOI: 10.3870/j.issn.1004-0781.2019.11.030.

33.袁珊, 陈楠, 卢翠翠, 等. “双通道”背景下定点零售药店药事管理及药学服务现状质性研究[J]. 中国药业, 2023, 32(4): 6-10. [Yuan S, Chen N, Lu CC, et al. Qualitative research on the current situation of pharmaceutical administration and pharmaceutical care in designated retail drugstores under the dual-channel background[J]. China Pharmaceuticals, 2023, 32(4): 6-10.] DOI: 10.3969/j.issn.1006-4931.2023.04.002.

34.陶颖, 徐晓媛, 王欣耀. 社会药房开展慢病照护的可行性分析[J]. 广东药科大学学报, 2018, 34(6): 97-102. [Tao Y, Xu XY, Wang XY. Feasibility analysis of developing chronic disease care in social pharmacy[J]. Journal of Guangdong Pharmaceutical University, 2018, 34(6): 97-102.] DOI: 10.16809/j.cnki.2096-3653. 2018082203.