Sequential screening for diabetes - evaluation of a campaign in Swiss community pharmacies
Sequential screening for diabetes - evaluation of a campaign in Swiss community pharmacies
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DOI：
10.1007/s11096-006-9034-6
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发表时间：
2006-06-01
影响因子：
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通讯作者：
Bruppacher, Rudolf
中科院分区：
文献类型：
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作者：
Hersberger, Kurt E.;Botomino, Andrea;Bruppacher, Rudolf
为了及早发现有 2 型糖尿病风险的人，危险因素评估和血糖测量相结合可能是一种有前途的方法，也是促进健康的机会。本研究的目的是开发一个序贯筛查概念，并在全国药房筛查活动中对其进行评估。参与“立即停止糖尿病测试”全国自我护理运动的瑞士德语区的社区药房提供免费的“序贯筛查”，其中包括（a）糖尿病风险评估，（b）连续毛细血管血糖测量和（c）基于行为改变的跨理论模型（TTM）的生活方式改变动机评估。 35 项数据表作为结构化筛选方案，可快速、可靠地记录所有相关数据。结果测量包括：年龄、性别、吸烟、ADA糖尿病危险因素问卷总分、糖尿病家族史、体重指数、体力活动不足、血压、毛细血管血糖、改变生活方式的动机、咨询活动和药房团队的分类决定。在2002年春季的5周期间，530家药房总共筛查了93,258人（33.1%为男性，平均年龄60.9岁） +/- 14.1 (SD))。风险概况：糖尿病家族史26.4%；体重指数≥25公斤/米(2) 49.3%；身体活动量低 27.2%；血压升高45.7%。风险组分层：< 2 个风险因素 21.6%； >= 2个危险因素71.5%；临界血糖（FG 5.3-6.1 mmol/l，在第二次测量中得到证实）为 2.5%，高血糖（FG >= 6.1 mmol/1 或 NFG >= 11.1 mmol/1）为 4.4%。在所有接受筛查的人中，6.4% 的人被转诊至医生，73.7% 的人根据其具体风险状况获得了有关身体活动和/或营养的有针对性的建议。筛查该活动吸引了很大一部分瑞士德语成年人（2.4%）。序贯筛选可以成功地应用于药房实践。在接受筛查的一般老年人中，6.9% 的人被检测出怀疑患有 2 型糖尿病，71.5% 的人至少有两种危险因素。这提供了一个机会来启动有关治疗性生活方式改变的有针对性的咨询。
For early detection of persons at risk for type 2 diabetes, a combination of risk factor assessment and glucose measurement could be a promising approach and an opportunity for health promotion. The object of this study was to develop a sequential screening concept and to evaluate it in a national pharmacy based screening campaign.Community pharmacies of the German speaking part of Switzerland participating in the national Self Care campaign "Stop diabetes-test now" offered a free of charge "sequential screening" with (a) diabetes risk assessment, (b) consecutive capillary blood glucose measurement and (c) assessment of the motivation for lifestyle change based on the Transtheoretical Model (TTM) of behaviour change. A 35 items data sheet served as a structured screening protocol and enabled quick and reliable documentation of all relevant data. Outcomes measures were: age, sex, cigarette smoking, total score of the ADA diabetes risk-factor questionnaire, family history of diabetes, body mass index, insufficient physical activity, blood pressure, capillary blood glucose, motivation for lifestyle change, counselling activities and triage decisions of the pharmacy team.During the 5 weeks of spring 2002, 530 pharmacies screened a total of 93,258 persons (33.1% male, mean age 60.9 years +/- 14.1 (SD)). Risk profile: family history of diabetes 26.4%; BMI >= 25 kg/m(2) 49.3%; low physical activity 27.2%; elevated blood pressure 45.7%. Stratification into risk groups: < 2 risk factors 21.6%; >= 2 risk factors 71.5%; borderline glycaemia (FG 5.3-6.1 mmol/l, confirmed in a second measurement) 2.5% and hyperglycaemia (FG >= 6.1 mmol/1 or NFG >= 11.1 mmol/1) 4.4%.Of all persons screened, 6.4% were referred to a physician and 73.7% got targeted advice with respect to physical activity and/or nutrition based on their specific risk profile.The screening campaign attracted an important part of Swiss German speaking adults (2.4%). The sequential screening could successfully be implemented into pharmacy practice. Of the generally elderly persons screened, 6.9% were detected with suspicion for diabetes type 2 and 71.5% had at least two risk factors. This provided an opportunity to initiate targeted counselling regarding therapeutic lifestyle change.