Kah Woon Teoh, Choon Ming Ng, Chun Wie Chong, Yi Ling Ng, J Simon Bell, Shaun Wen Huey Lee
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The intervention group received support of in-depth counselling from pharmacists, in-app prediabetes education modules, and peer support, while the usual care group received counselling based on pharmacists' usual practice. The primary outcomes were the proportion of participants achieving ≥5 % weight loss and differential change in weight. All analyses were performed using intention to treat analyses with mixed effect modelling.</p><p><strong>Findings: </strong>Ninety-one participants (intervention, n = 46; usual care n = 45) were recruited. At the end of study, participants in the intervention group were twice as likely compared to the usual care group to report a minimum 5 % weight loss (21 % intervention and 7.5 % usual care participants, odds ratio: 2.5, p = 0.266). Intervention group participants also reported a larger weight loss, with a mean difference of 1.26 kg (95 %CI -2.36 kg to -0.15 kg) between groups. 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引用次数: 0
摘要
背景：缺乏关于使用数字健康工具促进社区药房糖尿病前期管理的影响的证据。本研究旨在评估马来西亚数字健康支持和基于社区药房的生活方式干预（PRIME）计划对前驱糖尿病患者的影响。方法：在马来西亚两个州的16个社区药房进行了一项双组随机对照试验，其中包括超重或肥胖的前驱糖尿病患者。干预组以药师深度咨询、app内糖尿病前期教育模块、同伴支持为支持，常规护理组以药师惯例为支持。主要结局是体重减轻≥5%的参与者比例和体重差异变化。所有分析均采用混合效应模型进行意向处理分析。结果：招募了91名参与者（干预组，n = 46；常规组，n = 45）。在研究结束时，干预组的参与者报告体重减轻至少5%的可能性是常规护理组的两倍（21%的干预和7.5%的常规护理参与者，优势比：2.5,p = 0.266）。干预组的参与者也报告了更大的体重减轻，组间平均差异为1.26 kg （95% CI -2.36 kg至-0.15 kg）。这些差异更显著，尤其是那些更参与PRIME的人。结论：与常规护理相比，干预显示出更大的体重减轻，但达到临床有意义的体重减轻（≥5%）的个体比例并不显著。PRIME计划可以成为改善糖尿病前期个体风险因素的重要而有用的工具，特别是在资源匮乏的环境中。需要进一步的研究来确定这些项目的经济和长期可持续性。
A digital health-supported community pharmacy-based lifestyle intervention program for overweight or obese adults with prediabetes, the PRediabetes Intervention, Management and Evaluation (PRIME) Program: A cluster randomized controlled trial.
Background: Evidence on the impact of using digital health tools to facilitate prediabetes management in community pharmacies is lacking. This study aimed to evaluate the effects of a digital health-supported and community pharmacy-based lifestyle intervention (PRIME) program on individuals with prediabetes in Malaysia.
Methods: A two-arm cluster randomised controlled trial was conducted in 16 community pharmacies from two states in Malaysia and included people with prediabetes that were overweight or obese. The intervention group received support of in-depth counselling from pharmacists, in-app prediabetes education modules, and peer support, while the usual care group received counselling based on pharmacists' usual practice. The primary outcomes were the proportion of participants achieving ≥5 % weight loss and differential change in weight. All analyses were performed using intention to treat analyses with mixed effect modelling.
Findings: Ninety-one participants (intervention, n = 46; usual care n = 45) were recruited. At the end of study, participants in the intervention group were twice as likely compared to the usual care group to report a minimum 5 % weight loss (21 % intervention and 7.5 % usual care participants, odds ratio: 2.5, p = 0.266). Intervention group participants also reported a larger weight loss, with a mean difference of 1.26 kg (95 %CI -2.36 kg to -0.15 kg) between groups. These differences were more significant especially among those who were more engaged with PRIME.
Conclusion: The intervention showed greater weight loss than the usual care, but the proportion of individuals achieving clinically meaningful weight loss (≥5 %) was not significant. PRIME program can be an important and useful tool to improve risk factors among individuals with prediabetes especially in a low-resource setting. Further research is needed to determine the economic and long-term sustainability of such programs.
期刊介绍：
Research in Social and Administrative Pharmacy (RSAP) is a quarterly publication featuring original scientific reports and comprehensive review articles in the social and administrative pharmaceutical sciences. Topics of interest include outcomes evaluation of products, programs, or services; pharmacoepidemiology; medication adherence; direct-to-consumer advertising of prescription medications; disease state management; health systems reform; drug marketing; medication distribution systems such as e-prescribing; web-based pharmaceutical/medical services; drug commerce and re-importation; and health professions workforce issues.
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