Medication therapy management of a diabetic patient complicated with cardiovascular disease
- VernacularTitle:1例糖尿病合并心血管疾病患者的药物治疗管理
- Author:
Jigang SI
1
;
Xue SUN
1
;
Jianqiao ZHANG
1
;
Yedong WEI
1
;
Yuexuan WANG
1
Author Information
1. Dept. of Pharmacy,Zibo Central Hospital,Shandong Zibo 255036,China
- Publication Type:Journal Article
- Keywords:
medication therapy management;
pharmaceutical outpatient department;
diabetes;
cardiovascular disease;
drug
- From:
China Pharmacy
2024;35(19):2416-2421
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide reference for medication therapy management (MTM) of diabetic patients complicated with cardiovascular disease. METHODS A 63-year-old male diabetic patient who suffered from temporary headache every morning after percutaneous coronary intervention (PCI) visited the neurology department of our hospital, and then was recommended to the pharmaceutical outpatient department. The pharmacists thought that the patient’s symptoms of headache, severe constipation and hyperuricemia were more likely induced by the medication used. The pharmacists further found that his atherosclerotic cardiovascular disease (ASCVD) influencing factors such as blood pressure, heart rate, blood glucose and blood lipids did not reach standard. The pharmacists provided MTM services for the patient through pharmacy inquiry and adverse drug reactions judgement, medication evaluation, medication reconciliation, medication education and pharmacy follow-up. RESULTS Through fifteen MTM services for thirteen weeks, the pharmacists reconciliated and optimized the medication therapy plan, discontinued the use of Isosorbide mononitrate sustained-release tablets, Nifedipine controlled-release tablets, and Indapamide tablets, which caused adverse drug reactions; the number of drugs was adjusted from fifteen to seven, and the symptom of headache disappeared; severe constipation had also been significantly improved, and hyperuricemia dropped to normal range. The ASCVD influencing factors of blood pressure, heart rate, fasting plasma glucose, glycosylated hemoglobin, low-density lipoprotein cholesterol and uric acid were reduced from >140/90 mmHg(1 mmHg=0.133 kPa), 70-80 beats per minute, 7.71 mmol/L, 7.2%, 2.13 mmol/L and 494 μmol/L before MTM services to <130/80 mmHg, 55-60 beats per minute, 6.22 mmol/L, 6.3%, 1.55 mmol/L and 348 μmol/L after MTM services. CONCLUSIONS The pharmacists providing MTM services to the patients can improve their quality of life and therapeutic efficacy, reduce medication risks, and enhance the level of rational drug use in hospitals and pharmaceutical service capabilities.