Zahra Jahangard-Rafsanjani1, Amir Sarayani2, Marzieh Nosrati3, Navid Saadat4, Arash Rashidian5, Molouk Hadjibabaie6, Asieh Ashouri2, Mania Radfar1, Mohammadreza Javadi6, Kheirollah Gholami6. 1. Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran (Dr Jahangard-Rafsanjani, Dr Radfar) 2. Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran (Dr Sarayani, Dr Ashouri) 3. Community and Institutional Pharmacies, Tehran University of Medical Sciences, Tehran, Iran (Dr Nosrati) 4. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran (Dr Saadat) 5. Department of Health Management and Economics, School of Pubic Health, Tehran University of Medical Sciences, Tehran, Iran (Dr Rashidian) 6. Research Center for Rational Use of Drugs and Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran (Dr Hadjibabaie, Dr Javadi, Dr Gholami)
Abstract
PURPOSE: The purpose of the study was to investigate the efficacy of a community pharmacist-delivered diabetes support program for patients receiving specialty medical care in a middle-income country (Iran). METHODS: A randomized controlled trial was conducted on 101 patients who received diabetes care from an endocrinologist. A qualified community pharmacist educated patients about medications, clinical goals, self-care activities, and self-monitoring of blood glucose. The pharmacist trained patients in the intervention group for 5 months (5 follow-up visits and 5 phone calls) and recommended physician visits when necessary. The primary outcome was A1C, and the secondary outcomes included self-care activities, medication adherence, blood pressure, and body mass index. Satisfaction and willingness to pay was assessed in the intervention group. RESULTS:Eighty-five patients completed the study, and baselineA1C was similar between groups (intervention: 7.6 ± 1.6 [59 mmol/mol] vs control: 7.5 ± 1.9 [58 mmol/mol]). No significant difference was observed between study groups at the end of the trial period; however, the amount of A1C reduction was higher in the intervention group (1.0% ± 1.5% vs 0.5% ± 1.5%). Self-care activity was improved in general diet, blood glucose monitoring, and foot care subcategories in the intervention group. Medication adherence and body mass index were significantly improved in the intervention group at the end of study. CONCLUSIONS: A community pharmacist intervention improved self-care activity, medication adherence, and body mass index in patients receiving specialty medical care. Baseline A1C values and the presence of specialty medical care should be considered in the interpretation of clinical findings.
RCT Entities:
PURPOSE: The purpose of the study was to investigate the efficacy of a community pharmacist-delivered diabetes support program for patients receiving specialty medical care in a middle-income country (Iran). METHODS: A randomized controlled trial was conducted on 101 patients who received diabetes care from an endocrinologist. A qualified community pharmacist educated patients about medications, clinical goals, self-care activities, and self-monitoring of blood glucose. The pharmacist trained patients in the intervention group for 5 months (5 follow-up visits and 5 phone calls) and recommended physician visits when necessary. The primary outcome was A1C, and the secondary outcomes included self-care activities, medication adherence, blood pressure, and body mass index. Satisfaction and willingness to pay was assessed in the intervention group. RESULTS: Eighty-five patients completed the study, and baseline A1C was similar between groups (intervention: 7.6 ± 1.6 [59 mmol/mol] vs control: 7.5 ± 1.9 [58 mmol/mol]). No significant difference was observed between study groups at the end of the trial period; however, the amount of A1C reduction was higher in the intervention group (1.0% ± 1.5% vs 0.5% ± 1.5%). Self-care activity was improved in general diet, blood glucose monitoring, and foot care subcategories in the intervention group. Medication adherence and body mass index were significantly improved in the intervention group at the end of study. CONCLUSIONS: A community pharmacist intervention improved self-care activity, medication adherence, and body mass index in patients receiving specialty medical care. Baseline A1C values and the presence of specialty medical care should be considered in the interpretation of clinical findings.
Authors: Mícheál de Barra; Claire L Scott; Neil W Scott; Marie Johnston; Marijn de Bruin; Nancy Nkansah; Christine M Bond; Catriona I Matheson; Pamela Rackow; A Jess Williams; Margaret C Watson Journal: Cochrane Database Syst Rev Date: 2018-09-04
Authors: Joseph Linju Maria; T N Anand; Boban Dona; Jose Prinu; Dorairaj Prabhakaran; Panniyammakal Jeemon Journal: Lancet Glob Health Date: 2020-11-23 Impact factor: 26.763