INTERVENTION OF CLINICAL PHARMACIST IN THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS IN OUTPATIENTS
Keywords:Diabetes mellitus, Clinical pharmacist, Intervention, Glycosylated hemoglobin
Objective: The purpose of the study was to analyze the effect of clinical pharmacist intervention on glycemic control based on fasting blood glucose and glycosylated blood glucose level.
Methods: A randomized prospective interventional study was conducted in the outpatient department of a tertiary care hospital. Patients suffering from diabetes for a least 2 y were selected for the study based on the inclusion and exclusion criteria. The control group was not given any special pharmacist care, while the interventional group had a face-to-face interview, counseling, and telephonic follow-up during the study period. Based on the baseline values and endpoint parametric values, the result of the study was analyzed.
Results: The study was analyzed based on the difference in the glycemic index, using HbA1c and FBS values. The basal values of HbA1c were similar for both groups (8.5%), but a marked reduction to 7.2% was observed in the interventional group. FBS values reduced from 208 mg/dl to 186 mg/dl in the intervention group, while in the usual care group, the reduction was from 211 mg/dl to 198 mg/dl.
Conclusion: The inclusion of clinical pharmacists in the healthcare team can offer a remarkable improvement in patient's condition by providing more support in the therapy.
Lindenmeyer A, Hearnshaw H, Vermeire E, Van Royen P, Wens J, Biot Y. Interventions to improve adherence to medication in people with type 2 diabetes mellitus: a review of the literature on the role of pharmacists. J Clin Pharm Ther. 2006;31(5):409-19. doi: 10.1111/j.1365-2710.2006.00759.x, PMID 16958818.
Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, Wright AD, Turner RC, Holman RR. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 Diabetes (UKPDS 36): prospective observational study. BMJ. 2000;321(7258):412-9. doi: 10.1136/bmj.321.7258.412, PMID 10938049.
Blalock Susan J, Roberts Andrew W, Lauffenburger Julie C, Thompson Trey, O’Connor Shanna K. The effect of community pharmacy-based interventions on patient health outcomes: a systematic review. Med Care Res Rev. 2013;70(3):235-66. doi: 10.1177/1077558712459215, PMID 23035056.
Chrvala Carole A, Sherr Dawn, Lipman Ruth D. Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient Educ Couns. 2016;99(6):926-43. doi: 10.1016/ j.pec.2015.11.003, PMID 26658704.
Benedict Amanda, W Spence, Michele M, Sie John L, Chin Helen A, Ngo Chi D, Salmingo Jennifer F, Vidaurreta Andrew T, Rashid Nazia. Evaluation of a pharmacist-managed diabetes program in a primary care setting within an integrated health care system. J Manag Care Spec Pharm. 2018 Feb;24(2):114-22. doi: 10.18553/jmcp.2018.24.2.114, PMID 29384029.
Choe Hae Mi, Mitrovich Sonya, Dubay Daniel, Hayward Rodney A, Krein Sarah L, Vijan Sandeep. Proactive case management of high-risk patients with type 2 diabetes mellitus by a clinical pharmacist: A randomized controlled trial. Am J Manag Care. 2005;11(4):253-60. PMID 15839185.
Renders CM, Valk GD, Griffin SJ, Wagner EH, Eijk Van JT, Assendelft WJ. Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review. Diabetes Care. 2001;24(10):1821-33. doi: 10.2337/diacare.24.10.1821. PMID 11574449.
Korcegez Eylem Ilktac, Sancar Mesut, Demirkan Kutay. Effect of a pharmacist-led program on improving outcomes in patients with type 2 diabetes mellitus from northern cyprus: a randomized controlled trial. J Manag Care Spec Pharm. 2017;23(5):573-82. doi: 10.18553/jmcp.2017.23.5.573, PMID 28448779.
Bukhsh Allah, Khan Tahir M, Lee Shaun WH, Lee Learn-Han, Chan Kok-Gan, Goh Bey-Hing. Efficacy of pharmacist-based diabetes educational interventions on clinical outcomes of adults with type 2 diabetes mellitus: a network meta-analysis. Front Pharmacol. 2018;9:339. doi: 10.3389/fphar.2018.00339, PMID 29692730.
Jarab Anan Sadeq, Alqudah Salam Ghazi, Mukattash Tareq Lewis, Shattat Ghassan, Al-Qirim Tariq. Randomized controlled trial of clinical pharmacy management of patients with type 2 diabetes in an outpatient diabetes clinic in Jordan. J Manag Care Pharm. 2012;18(7):516-26. doi: 10.18553/jmcp.2012.18.7.516. PMID 22971205.
Presley Bobby, Groot Wim, Pavlova Milena. Pharmacy-led interventions to improve medication adherence among adults with diabetes: a systematic review and meta-analysis. Res Social Adm Pharm. 2019;15(9):1057-67. doi: 10.1016/j.sapharm.2018.09.021. PMID 30685443.
Mathew Arun, Palur Venkat, Venkateswaramurthy. A study of impact of clinical pharmacist intervention on the relationship between treatment satisfaction and medication adherence in hypertensive patients. J Pharm Sci Res. 2016;8:190-7.
Funnell Martha M, Brown Tammy L, Childs Belinda P, Haas Linda B, Hosey Gwen M, Jensen Brian, Maryniuk Melinda, Peyrot Mark, Piette John D, Reader Diane, Siminerio Linda M, Weinger Katie, Weiss Michael A. National standards for diabetes self-management education. Diabetes Care. 2009;32;Suppl 1:S87-94. doi: 10.2337/dc09-S087, PMID 19118294.
Sauriasari Rani, Sakti Ridho Muhammad. Impact of a pharmacist-led patient education initiative on glycemic control of patients with type 2 diabetes mellitus: a single-center experience in West Jakarta, Indonesia. Int J App Pharm. 2018;10(1):252-6. doi: 10.22159/ijap.2018.v10s1.56.
Yaghoubi Mohsen, Mansell Kerry, Vatanparastc Hassanali, Steeves Megan, Zeng, Farag Marwa. Effects of pharmacy-based interventions on the control and management of diabetes in adults: a systematic review and meta-analysis. Can J Diabetes. 2017;41(6):628-41. doi: 10.1016/j.jcjd.2017.09.014, PMID 29224636.
Syed Wajid Menaka M, Ahmed Fazil, Samreen Sana. A literature review on oral hypoglycemic agents-mechanistic aspects. Asian J Pharm Clin Res. 2019;12:5-10.
Butt Mubashra, Mhd Ali Adliah, Bakry Mohd Makmor, Mustafa Norlaila. Impact of a pharmacist-led diabetes mellitus intervention on HbA1c, medication adherence and quality of life: a randomised controlled study. Saudi Pharm J. 2016;24(1):40-8. doi: 10.1016/j.jsps.2015.02.023. PMID 26903767.
Toklu Hale Zerrin, Hussain Azhar. The changing face of pharmacy practice and the need for a new model of pharmacy education. J Young Pharm. 2013;5(2):38-40. doi: 10.1016/j.jyp.2012.09.001, PMID 24023452.
Chung Nancy, Rascati Karen, Lopez Debra, Jokerst Jason, Garza Aida. Impact of a clinical pharmacy program on changes in hemoglobin A1c, diabetes-related hospitalizations, and diabetes-related emergency department visits for patients with diabetes in an underserved population. J Manag Care Spec Pharm. 2014;20(9):914-9. doi: 10.18553/jmcp.2014.20.9.914, PMID 25166290.
Holsclaw Susan L, Olson Kari L, Hornak Roseanne, Denham Anne M. Assessment of patient satisfaction with telephone and mail interventions provided by a clinical pharmacy cardiac risk reduction service. J Manag Care Pharm. 2005;11(5):403-9. doi: 10.18553/jmcp.2005.11.5.403. PMID 15934799.
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