BACKGROUND: Brazilians with type 2 diabetes require action to improve haemoglobin A1C levels considering the fact that approximately 73 % of them have poor glycaemic control. Evidence has shown the potential benefits of pharmaceutical care programs in type 2 diabetes patients. OBJECTIVE: To evaluate the effect of a pharmaceutical care program on blood glucose, blood pressure and lipid profile in hyperglycaemic patients undergoing drug treatment for type 2 diabetes. SETTING:Six primary care units of the Brazilian public health system, Ouro Preto, Brazil. METHOD: An open, randomised, controlled clinical trial was conducted for 6 months. Subjects aged 18 years or older who were using oral antidiabetic medications and presenting haemoglobin A1C levels ≥7 % were randomly assigned to receive only usual health care or usual health care plus pharmaceutical intervention. Main outcome measure Haemoglobin A1C. RESULTS:A total of 129 subjects were enrolled, and 100 patients completed the study. Compared to the control group (n = 50), the intervention group (n = 50) showed a significant reduction of haemoglobin A1C (-0.6 vs 0.7 %, p = 0.001), fasting plasma glucose, total cholesterol, LDL cholesterol, triglycerides and systolic blood pressure and a significant increase in HDL cholesterol and the use of lipid-modifying agents and platelet aggregation inhibitors. CONCLUSIONS: This study suggests that a pharmaceutical care program may provide important contributions to reduce haemoglobin A1C in type 2 diabetes patients. Moreover, the promotion of the rational use of drugs may be better achieved in a context of pharmaceutical care programs in Brazil.
RCT Entities:
BACKGROUND: Brazilians with type 2 diabetes require action to improve haemoglobin A1C levels considering the fact that approximately 73 % of them have poor glycaemic control. Evidence has shown the potential benefits of pharmaceutical care programs in type 2 diabetespatients. OBJECTIVE: To evaluate the effect of a pharmaceutical care program on blood glucose, blood pressure and lipid profile in hyperglycaemic patients undergoing drug treatment for type 2 diabetes. SETTING: Six primary care units of the Brazilian public health system, Ouro Preto, Brazil. METHOD: An open, randomised, controlled clinical trial was conducted for 6 months. Subjects aged 18 years or older who were using oral antidiabetic medications and presenting haemoglobin A1C levels ≥7 % were randomly assigned to receive only usual health care or usual health care plus pharmaceutical intervention. Main outcome measure Haemoglobin A1C. RESULTS: A total of 129 subjects were enrolled, and 100 patients completed the study. Compared to the control group (n = 50), the intervention group (n = 50) showed a significant reduction of haemoglobin A1C (-0.6 vs 0.7 %, p = 0.001), fasting plasma glucose, total cholesterol, LDL cholesterol, triglycerides and systolic blood pressure and a significant increase in HDL cholesterol and the use of lipid-modifying agents and platelet aggregation inhibitors. CONCLUSIONS: This study suggests that a pharmaceutical care program may provide important contributions to reduce haemoglobin A1C in type 2 diabetespatients. Moreover, the promotion of the rational use of drugs may be better achieved in a context of pharmaceutical care programs in Brazil.
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