BACKGROUND: Care of the elderly with diabetes is more complicated than that for other age groups. The elderly and/or those with multiple comorbidities are often excluded from randomized controlled trials of treatments for diabetes. The heterogeneity of health status of the elderly also increases the difficulty in diabetes care; therefore, diabetes care for the elderly should be individualized. Motivated patients educated about diabetes benefit the most from collaborating with a multidisciplinary patient-care team. A pharmacist is an important team member by serving as an educator, coach, healthcare manager, and pharmaceutical care provider. OBJECTIVE: To evaluate the effects of pharmaceutical care on glycemic control of ambulatory elderly patients with type 2 diabetes. SETTING:A 421-bed district hospital in Nantou City, Taiwan. METHOD: We conducted a randomized controlled clinical trial involving 100 patients with type 2 diabetes with poor glycemic control (HbA1c levels of ≥9.0 %) aged ≥65 years over 6 months. Participants were randomly assigned to a standard-care (control, n = 50) or pharmaceutical-care (intervention, n = 50) group. Pharmaceutical care was provided by a certified diabetes-educator pharmacist who identified and resolved drug-related problems and established a procedure for consultations pertaining to medication. The Mann–Whitney test was used to evaluate nonparametric quantitative data. Statistical significance was defined as P < 0.05. MAIN OUTCOME MEASURE: The change in the mean HbA1c level from the baseline to the next level within 6 months after recruiting. RESULTS: Nonparametric data (Mann–Whitney test) showed that the mean HbA1c level significantly decreased (0.83 %) after 6 months for the intervention group compared with an increase of 0.43 % for the control group (P ≤ 0.001). Medical expenses between groups did not significantly differ (−624.06 vs. −418.7, P = 0.767). There was no significant difference in hospitalization rates between groups. CONCLUSION: The pharmacist intervention program provided pharmaceutical services that improved long-term, safe control of blood sugar levels for ambulatory elderly patients with diabetes and did not increase medical expenses.
RCT Entities:
BACKGROUND: Care of the elderly with diabetes is more complicated than that for other age groups. The elderly and/or those with multiple comorbidities are often excluded from randomized controlled trials of treatments for diabetes. The heterogeneity of health status of the elderly also increases the difficulty in diabetes care; therefore, diabetes care for the elderly should be individualized. Motivated patients educated about diabetes benefit the most from collaborating with a multidisciplinary patient-care team. A pharmacist is an important team member by serving as an educator, coach, healthcare manager, and pharmaceutical care provider. OBJECTIVE: To evaluate the effects of pharmaceutical care on glycemic control of ambulatory elderly patients with type 2 diabetes. SETTING: A 421-bed district hospital in Nantou City, Taiwan. METHOD: We conducted a randomized controlled clinical trial involving 100 patients with type 2 diabetes with poor glycemic control (HbA1c levels of ≥9.0 %) aged ≥65 years over 6 months. Participants were randomly assigned to a standard-care (control, n = 50) or pharmaceutical-care (intervention, n = 50) group. Pharmaceutical care was provided by a certified diabetes-educator pharmacist who identified and resolved drug-related problems and established a procedure for consultations pertaining to medication. The Mann–Whitney test was used to evaluate nonparametric quantitative data. Statistical significance was defined as P < 0.05. MAIN OUTCOME MEASURE: The change in the mean HbA1c level from the baseline to the next level within 6 months after recruiting. RESULTS: Nonparametric data (Mann–Whitney test) showed that the mean HbA1c level significantly decreased (0.83 %) after 6 months for the intervention group compared with an increase of 0.43 % for the control group (P ≤ 0.001). Medical expenses between groups did not significantly differ (−624.06 vs. −418.7, P = 0.767). There was no significant difference in hospitalization rates between groups. CONCLUSION: The pharmacist intervention program provided pharmaceutical services that improved long-term, safe control of blood sugar levels for ambulatory elderly patients with diabetes and did not increase medical expenses.
Authors: C H Chang; W Y Shau; Y D Jiang; H Y Li; T J Chang; W H-H Sheu; C F Kwok; L T Ho; L M Chuang Journal: Diabet Med Date: 2010-06 Impact factor: 4.359
Authors: Donna L McLean; Finlay A McAlister; Jeffery A Johnson; Kathryn M King; Mark J Makowsky; Charlotte A Jones; Ross T Tsuyuki Journal: Arch Intern Med Date: 2008-11-24
Authors: Seth T Cioffi; Michael F Caron; James S Kalus; Patricia Hill; Thomas E Buckley Journal: Ann Pharmacother Date: 2004-03-18 Impact factor: 3.154
Authors: Josep Franch-Nadal; Fermín García-Gollarte; Alfonso Pérez Del Molino; María L Orera-Peña; Marta Rodríguez de Miguel; Malena Melogno-Klinkas; Héctor D de Paz; Susana Aceituno; Patricia Rodríguez-Fortúnez Journal: Clin Drug Investig Date: 2019-01 Impact factor: 2.859
Authors: Verughese Jacob; Jeffrey A Reynolds; Sajal K Chattopadhyay; David P Hopkins; Nicole L Therrien; Christopher D Jones; Jeffrey M Durthaler; Kimberly J Rask; Alison E Cuellar; John M Clymer; Thomas E Kottke Journal: Am J Prev Med Date: 2021-12-04 Impact factor: 5.043
Authors: Allah Bukhsh; Tahir M Khan; Shaun W H Lee; Learn-Han Lee; Kok-Gan Chan; Bey-Hing Goh Journal: Front Pharmacol Date: 2018-04-10 Impact factor: 5.810
Authors: Francisco Martínez-Mardones; Fernando Fernandez-Llimos; Shalom I Benrimoj; Antonio Ahumada-Canale; José Cristian Plaza-Plaza; Fernanda S Tonin; Victoria Garcia-Cardenas Journal: J Am Heart Assoc Date: 2019-11-12 Impact factor: 5.501