The Effect of a Pharmacist-Intervention Program on Clinical Outcomes in Diabetes Mellitus Patients

Authors

  • Sini T Inasu Ahalia School of Pharmacy, Palakkad, Kerala, India
  • Kumudavalli MV Vinayaka Missions College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed University), Salem, Tamil Nadu, India
  • Venkateswarlu BS Vinayaka Missions College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed University), Salem, Tamil Nadu, India

DOI:

https://doi.org/10.55489/njcm.140920233128

Keywords:

pharmaceutical care, glycemic control, patient counselling, Diabetes Mellitus, Role of Pharmacist, Diabetes Self-Care, interventions

Abstract

Background: Clinical pharmacists are skilled in identifying patient medication-related problems such as adverse drug responses and non-adherence. Pharmacists participate in diabetes management teams and offer direct patient treatment using several practice models in different ambulatory practice settings. The objective is to evaluate the effect of a pharmacist-intervention program on clinical outcomes in diabetes mellitus patients.

Materials and methods: The cohort consisted of diabetes patients attending multi-speciality care hospitals. Eligible patients were randomly assigned in a 1:1 ratio to the intervention and control groups. Each patient in the intervention group was counselled by the research pharmacist. The measure of diabetes self-management was assessed using the Summary of Diabetes Self –Care activities (SDSCA) questionnaire.

Results: 150 patients out of this population met the inclusion criteria. The study succeeded in proving the effect of pharmacist-led patient education in the improvement of the quality of life and clinical parameters of diabetes.  The pronounced differences in the SDSCA scores of the test group and control group signify the impact of interventions and the consistency of the scale as well.

Conclusion: The effect of pharmacist-led interventions on diabetic treatment outcomes was evaluated. The results recommend the need for extensive pharmacist-led intervention programs in metabolic disorder management.

References

Alhabib S, Aldraimly M, Alfarhan A. An evolving role of clinical pharmacists in managing diabetes: Evidence from the litera-ture. Saudi Pharm J. 2016;24(4):441-446. Doi: https://doi.org/10.1016/j.jsps.2014.07.008 PMid:27330374 PMCid:PMC4908050

Wang A, Lv G, Cheng X, et al. Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition). Burns Trauma. 2020;8:017. Doi: https://doi.org/10.1093/burnst/tkaa017 PMid:32685563 PMCid:PMC7336185

Liu X, Li C, Gong H, et al. An economic evaluation for preven-tion of diabetes mellitus in a developing country: a modelling study. BMC Public Health. 2013;13:729. Doi: https://doi.org/10.1186/1471-2458-13-729 PMid:23919839 PMCid:PMC3751006

Azharuddin M, Adil M, Sharma M, Gyawali B. A systematic re-view and meta-analysis of non-adherence to anti-diabetic medication: evidence from low- and middle-income coun-tries. Int J Clin Pract. 2021;75:e14717. Doi: https://doi.org/10.1111/ijcp.14717 PMid:34378293

Khunti K, Gray LJ, Skinner T, et al. Effectiveness of a diabetes education and self-management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus: three year follow-up of a cluster randomised controlled trial in primary care. BMJ. 2012;344:e2333. Doi: https://doi.org/10.1136/bmj.e2333 PMid:22539172 PMCid:PMC3339877

Mishra V, Nayak P, Sharma M, et al. Emerging Treatment Strategies for Diabetes Mellitus and Associated Complica-tions: An Update. Pharmaceutics. 2021;13(10):1568. Doi: https://doi.org/10.3390/pharmaceutics13101568 PMid:34683861 PMCid:PMC8538773

Renders CM, Valk GD, Griffin S, Wagner EH, Eijk JT, Assendelft WJ. Interventions to improve the management of diabetes mellitus in primary care, outpatient and community set-tings. Cochrane Database Syst Rev. 2001;2000(1):CD001481. Doi: https://doi.org/10.1002/14651858.CD001481 PMid:11279717 PMCid:PMC7045779

Orabone AW, Do V, Cohen E. Pharmacist-Managed Diabetes Programs: Improving Treatment Adherence and Patient Out-comes. Diabetes Metab Syndr Obes. 2022; 15:1911-1923. Doi: https://doi.org/10.2147/DMSO.S342936 PMid:35757195 PMCid:PMC9231415

Venkatesan R, Devi AS, Parasuraman S, Sriram S. Role of com-munity pharmacists in improving knowledge and glycemic control of type 2 diabetes. Perspect Clin Res. 2012;3(1):26-31. Doi: https://doi.org/10.4103/2229-3485.92304 PMid:22347699 PMCid:PMC3275990

Van Eikenhorst L, Taxis K, van Dijk L, de Gier H. Pharmacist-Led Self-management Interventions to Improve Diabetes Outcomes. A Systematic Literature Review and Meta-Analysis. Front Pharmacol. 2017; 8:891. Doi: https://doi.org/10.3389/fphar.2017.00891 PMid:29311916 PMCid:PMC5735079

Nabulsi NA, Yan CH, Tilton JJ, Gerber BS, Sharp LK. Clinical pharmacists in diabetes management: What do minority pa-tients with uncontrolled diabetes have to say. J Am Pharm As-soc (2003). 2020;60(5):708-715. Doi: https://doi.org/10.1016/j.japh.2020.01.024 PMid:32115392 PMCid:PMC7483142

Kesavadev J, Misra A, Saboo B, et al. Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization. Diabetes Metab Syndr. 2021;15(1):221-227. Doi: https://doi.org/10.1016/j.dsx.2020.12.032 PMCid:PMC8049470

Korcegez EI, Sancar M, Demirkan K. Effect of a Pharmacist-Led Program on Improving Outcomes in Patients with Type 2 Diabetes Mellitus from Northern Cyprus: A Randomized Controlled Trial. JMCP. 2017 May;23(5):573-82. Doi: https://doi.org/10.18553/jmcp.2017.23.5.573 PMid:28448779 PMCid:PMC10397999

Kamradt M, Bozorgmehr K, Krisam J, et al. Assessing self-management in patients with diabetes mellitus type 2 in Ger-many: validation of a German version of the Summary of Dia-betes Self-Care Activities measure (SDSCA-G). Health Qual Life Outcomes. 2014; 12:185. Doi: https://doi.org/10.1186/s12955-014-0185-1 PMid:25519204 PMCid:PMC4297436

Skinner TC, Carey ME, Cradock S, et al. Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND): process modelling of pilot study. Patient Educ Couns. 2006;64(1-3):369-377. Doi: https://doi.org/10.1016/j.pec.2006.04.007 PMid:17011154

Toobert DJ, Hampson SE, Glasgow RE. The summary of diabe-tes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000 Jul 1;23(7):943-50. Doi: https://doi.org/10.2337/diacare.23.7.943 PMid:10895844

Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;23;340:c332. Doi: https://doi.org/10.1136/bmj.c332 PMid:20332509 PMCid:PMC2844940

Kirwan JP, Sacks J, Nieuwoudt S. The essential role of exercise in the management of type 2 diabetes. Cleve Clin J Med. 2017; 84(7 Suppl 1):S15-S21. Doi: https://doi.org/10.3949/ccjm.84.s1.03 PMid:28708479 PMCid:PMC5846677

Umpierre D, Ribeiro PAB, Schaan BD, Ribeiro JP. Volume of supervised exercise training impacts glycaemic control in pa-tients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia. 2013;56:242-251. Doi: https://doi.org/10.1007/s00125-012-2774-z PMid:23160642

Debjit B, Chiranjib B, Jitender Y, Chandira MR. Role of commu-nity pharmacist in management and prevention diabetic foot ulcer and infections. Journal of Chemical and Pharmaceutical Research. 2009;1(1):38-53.

Subbu Lakshmi S, Chelladurai G, Suresh B. In vitro studies on medicinal plants used against bacterial diabetic foot ulcer (BDFU) and urinary tract infected (UTI) causing pathogens. J Parasit Dis. 2016;40(3):667-673. Doi: https://doi.org/10.1007/s12639-014-0555-y PMid:27605764 PMCid:PMC4996168

https://www.cdc.gov/diabetes/managing/eat-well/meal-plan-method.html.

White ND. Produce Prescriptions, Food Pharmacies, and the Potential Effect on Food Choice. Am J Lifestyle Med. 2020;14(4):366-368. Doi: https://doi.org/10.1177/1559827620915425 PMid:33281515 PMCid:PMC7692008

Ausili D, Bezze S, Canizzaro C, Bulgheroni M, Toolbert DJ, Gen-ovese S, et al. [Self-care assessment in type-2 diabetes: the Italian translation and validation of the Summary of Diabetes Self-Care Activities]. Prof Inferm. 2015;68(1):9-18.

Kamradt M, Bozorgmehr K, Krisam J, Freund T, Kiel M, Qreini M, et al. Assessing self-management in patients with diabetes mellitus type 2 in Germany: validation of a German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G). Health Qual Life Outcomes. 2014;12:185. Doi: https://doi.org/10.1186/s12955-014-0185-1 PMid:25519204 PMCid:PMC4297436

Mourão AO, Ferreira WR, Martins MA, et al. pharmaceutical care program for type 2 diabetes patients in Brazil: a random-ised controlled trial. Int J Clin Pharm. 2013;35(1):79-86. Doi: https://doi.org/10.1007/s11096-012-9710-7 PMid:23161124

Jarab AS, Alqudah SG, Mukattash TL, Shattat G, Al-Qirim T. Randomized controlled trial of clinical pharmacy manage-ment of patients with type 2 diabetes in an outpatient diabe-tes clinic in Jordan. J Manag Care Pharm. 2012;187(7):516-26. Doi: https://doi.org/10.18553/jmcp.2012.18.7.516 PMid:22971205 PMCid:PMC10437536

Choe HM, Mitrovich S, Dubay D, Hayward RA, Krein SL, Vijan S. 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.

Al Mazroui NR, Kamal MM, Ghabash NM, Yacout TA, Kole PL, McElnay JC. Influence of pharmaceutical care on health out-comes in patients with Type 2 diabetes mellitus. Br J Clin Pharmacol. 2009;67(5):547-57. Doi: https://doi.org/10.1111/j.1365-2125.2009.03391.x PMid:19552750 PMCid:PMC2686072

Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006;16(Suppl 1): S3-S63. Doi: https://doi.org/10.1111/j.1600-0838.2006.00520.x PMid:16451303

Deakin T, McShane CE, Cade JE, Williams RD. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;(2) CD003417. Doi: https://doi.org/10.1002/14651858.CD003417.pub2

Mehuys E, Van Bortel L, De Bolle L, Van Tongelen I, Annemans L, Remon JP, et al. Effectiveness of a community pharmacist intervention in diabetes care: a randomized controlled trial. J Clin Pharm Ther. 2011;36(5):602-13. Doi: https://doi.org/10.1111/j.1365-2710.2010.01218.x PMid:21143256

Clifford RM, Davis WA, Batty KT, Davis TM. Effect of a phar-maceutical care program on vascular risk factors in Type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care. 2005;28(4):771-76. Doi: https://doi.org/10.2337/diacare.28.4.771 PMid:15793171

Pousinho S, Morgado M, Falcão A, Alves G. Pharmacist ınter-ventions in the management of type 2 diabetes mellitus: a sys-tematic review of randomized controlled trials. J Manag Care Spec Pharm. 2016;22(5):493-515. Doi: https://doi.org/10.18553/jmcp.2016.22.5.493 PMid:27123912 PMCid:PMC10397609

Downloads

Published

2023-09-01

How to Cite

1.
Inasu ST, MV K, BS V. The Effect of a Pharmacist-Intervention Program on Clinical Outcomes in Diabetes Mellitus Patients. Natl J Community Med [Internet]. 2023 Sep. 1 [cited 2024 May 12];14(09):588-95. Available from: https://njcmindia.com/index.php/file/article/view/3128

Issue

Section

Original Research Articles