2023-04-20 カリフォルニア大学校アーバイン校(UCI)
世界各地からの研究をレビューした結果、患者が報告するアウトカムを取り入れた、広がりのある薬剤師の活動が含まれた医療モデルが最も効果的であることが判明した。この結果は、政策決定や現場での医療モデルの意思決定に役立つという。
<関連情報>
- https://news.uci.edu/2023/04/20/study-shows-importance-of-patient-reported-outcomes-in-diabetes-management-care-model/
- https://accpjournals.onlinelibrary.wiley.com/doi/full/10.1002/jac5.1770
糖尿病管理における薬剤師関与の共同ケアモデルの臨床活動とアウトカム指標に関するエビデンスをマッピングする: スコープレビュー Mapping the evidence on clinical activities and outcome measures of pharmacist-involved collaborative care models in managing diabetes: A scoping review
Zheng Kang Lum, Yingqi Xu, Paul John Gallagher, Joyce Yu-Chia Lee
Journal of the American College of Clinical Pharmacy Published: 01 March 2023
DOI:https://doi.org/10.1002/jac5.1770
Abstract
Objective
This scoping review aimed to map the extent and range of evidence on the clinical activities performed and types of outcomes evaluated in pharmacist-involved collaborative care models for diabetes management.
Methods
This scoping review was guided by the five-stage methodological framework developed by Arksey and O’Malley. Publications in the English language were identified from PubMed, EMBASE, and CINAHL and the databases were searched from inception to 31 May 2022. Abstracts, conference proceedings, brief reports, and commentaries were excluded. Key search terms were “interprofessional collaborative care,” “pharmacist,” “type 2 diabetes,” and “outcome.” Microsoft Excel was used for data charting and descriptive computations were conducted using the Statistical Package for Social Sciences.
Results
A total of 208 articles were identified, and after excluding 178 articles (and duplicates), 30 articles were reviewed. Most of the studies (56.7%) were conducted in the United States of America and were randomized controlled trials (50.0%) followed by cohort studies (36.7%). The most common clinical activity identified was provision of health- and medication-related education (80.0%), followed by lifestyle counseling (76.7%) and development of individualized care plan and goal setting (63.3%). Other clinical activities were review of laboratory records, medication review and dose adjustments, optimization of medication adherence, minimization of drug-related problems, identify referral to other care providers, and conduct physical assessments. HbA1c was the most reported clinical outcome (n = 26, 86.7%), with 11 studies evaluating patient-reported outcomes (PROs) such as medication adherence, diabetes knowledge, self-care, quality of life, diabetes distress, and treatment satisfaction.
Conclusion
Clinical activities performed by pharmacists were heterogenous across studies and based on patients’ needs. While pharmacist-involved collaborative care models were posited as person-centric outcome, PROs were lacking in most studies. Evaluating PROs are essential in guiding the implementation of such people-centric care models.
