中国临床药学杂志

目的 分析临床药师参与的“糖尿病综合门诊”在糖尿病患者管理中的成本-效果。方法 通过HIS系统选取2019年1月-2020年1月在内分泌科门诊就诊的新诊断的2型糖尿病患者，按照就诊时间先后进行编号，参考随机数字表法，按1∶1分为对照组（常规门诊就诊的患者）和试验组（“糖尿病综合门诊”就诊的患者）。评估2组患者入组时和管理6个月后的血糖指标及用药依从性，并进行成本-效果分析。结果 试验组患者的空腹血糖、餐后2 h血糖和糖化血红蛋白（Hb A1c）均较入组时有显著降低（P <0.05）；常规门诊就诊的患者各项指标有所改善，但差异无统计学意义（P> 0.05）。成本-效果分析显示，对照组Hb A1c达标率增加1%的所需成本为72.82元，而试验组仅需49.06元。结论 “糖尿病综合门诊”以团队模式为糖尿病患者提供一站式服务，不仅有利于提高降糖效果，还具有经济学意义，值得推广。

AIM To explore the cost-effectiveness of the "diabetes comprehensive clinic" with the participation of clinical pharmacists in the management of diabetic patients. METHODS Newly diagnosed type 2 diabetic patients who were treated in our hospital's endocrinology outpatient department from January 2019 to January 2020 were selected through HIS system and numbered according to the time of treatment. The patients were divided into control group and experimental group at a rate of 1:1 according to the random number table method. The patients of control group were treated in the routine outpatient department, and the patients of experimental group were treated in the "diabetes comprehensive clinic". The blood glucose indexes and medication compliance of the 2 groups were evaluated at the time of enrollment and 6 months after management, and cost-effectiveness analysis was performed. RESULTS Fasting blood glucose, postprandial blood glucose, and glycosylated hemoglobin(HbA1c)in the experimental group were significantly decreased(P < 0.05), and the indexes of patients in routine outpatient department were improved, but there was no significant difference(P > 0.05). The cost-effectiveness analysis showed that the cost required to increase HbA1c compliance rate by 1%in the control group was 72.82 yuan, while that in the experimental group was only 49.06 yuan. CONCLUSION "Diabetes comprehensive clinic" provides one-stop service for diabetic patients in a team mode, which is not only beneficial to improve the effect of hypoglycemia, but also economical and worthy of promotion.