2型糖尿病患者药学服务质量评价与影响因素分析OA

AIM To establish a quality evaluation system for pharmaceutical care in patients with type 2 diabetes mellitus(T2DM),identify existing problems,and analyze influencing factors.METHODS A total of 182 hospitalized T2DM patients were selected from October 2022 to April 2023.An evaluation framework comprising 19 secondary indicators was constructed based on the structure-process-outcome(SPO)model.The Delphi method and the attribute hierarchy model(AHM)were employed to determine indicator weights.A six-month pharmaceutical care intervention was delivered collaboratively by clinical and community pharmacists.The weighted technique for order preference by similarity to ideal solution(TOPSIS)was used to calculate individual service quality scores,while univariate analysis and multiple linear regression were applied to identify influencing factors.RESULTS The mean pharmaceutical care quality score for all patients was 0.570 9±0.076 6,suggesting moderate overall performance with room for improvement.Indicators related to antidiabetic medication costs and disease control accounted for the greatest reductions in score.Significant differences in quality scores were observed among patients when stratified by age,household income,disease duration,diabetic nephropathy stage,glucose-lowering treatment strategy,and presence of lower extremity vascular disease(all P＜0.05).Multiple linear regression indicated that age(β=0.161),annual household income(β=0.224),and insulin-based therapy(β=0.286 for combination regimens;β=0.211 for monotherapy)were positively associated with pharmaceutical care quality.In contrast,disease duration(β=-0.165)and diabetic nephropathy stage(β=-0.304)showed negative correlations with service quality(all P＜0.05).CONCLUSION Greater attention should be paid to younger patients,those with longer disease duration,severe kidney disease,limited economic resources,and those on non-insulin regimens.Implementing diversified pharmaceutical care strategies to enhance prescription management and disease control is essential for improving the overall quality of pharmaceutical services.