PubMed日本語 - 2型糖尿病患者の複数の心血管リスク削減のための薬剤師主導の共有医学指定。―QLifePro医療翻訳医療翻訳 QLifePro


Pharmacist-led shared medical appointments for multiple cardiovascular risk reduction in patients with type 2 diabetes.


Published date



Lisa B Cohen, Tracey H Taveira, Sameed Ahmed M Khatana, Andrea G Dooley, Paul A Pirraglia, Wen-Chih Wu


Systems Outcomes and Quality in Chronic Disease andRehabilitation, Research Enhancement Award Program, Providence VA Medical Center, Providence, Rhode Island, USA.


PURPOSE: To assess whether VA MEDIC-E (Veterans Affairs Multi-disciplinary Education and Diabetes Intervention for Cardiac risk reduction[EM DASH] Extended for 6 months), a pharmacist-led shared medical appointments program, could improve attainment of target goals for hypertension, hyperglycemia, hyperlipidemia, and tobacco use in patients with type 2 diabetes compared to standard primary care after 6 months of intervention.


METHODS: A randomized, controlled trial of VA MEDIC-E (n = 50) versus standard primary care (n = 49) in veterans with type 2 diabetes, hemoglobin A1c (A1C) > 7%, blood pressure (BP) > 130/80 mmHg, and low density lipoprotein cholesterol (LDL-C) > 100mg/dl (2.59 mmol/l) in the previous 6 months was conducted. The VA MEDIC-E intervention consisted of 4 weekly group sessions followed by 5 monthly booster group sessions. Each 2-hour session included 1 hour of multidisciplinary diabetes specific healthy lifestyle education and 1 hour of pharmacotherapeutic interventions performed by a clinical pharmacist. Evaluation measures included lab values of A1C, LDL cholesterol, BP, and goal attainment of these values, and diabetes self-care behavior questionnaires at 6 months.


RESULTS: The randomization groups were similar at baseline in all cardiovascular risk factors except for LDL, which was significantly lower in the MEDIC-E arm. At 6 months, significant improvements from baseline were found in the intervention arm for exercise, foot care, and goal attainment of A1C, LDL-C, and BP but not in the control arm.


CONCLUSIONS: The results of this study demonstrate that the pharmacist-led group intervention program for 6 months was an efficacious and sustainable collaborative care approach to managing diabetes and reducing associated cardiovascular risk.


目的:VA MEDIC-E(CardiacのためのベテランAffairs Multi-規律EducationとDiabetes Interventionは、6ヵ月の間減少[EM DASH]Extendedの危険を冒す)(薬剤師主導の共有医学指定プログラム)が高血圧のために目標目的の達成を改善することができたかどうか判断するために、2型糖尿病患者における高血糖、高脂血症と喫煙は、6ヵ月の介入の後標準プライマリケアに匹敵した。
方法VA MEDIC-E(n = 50)の無作為比較試験対2型糖尿病のベテランにおける標準プライマリケア(n = 49)(ヘモグロビンA1c(A1C)) > 7%、血圧(血圧) > 130/80mmHgと低比重リポ蛋白コレステロール(LDLC) > 以前の6ヵ月間の100mg/dl(2.59mmol/l)は、実行された。
VA MEDIC-E介入は、5つの毎月の効果促進剤グループ・セッションが続く4つの毎週のグループ・セッションから成った。

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