Mohsen Yaghoubi1, Kerry Mansell2, Hassanali Vatanparastc3, Megan Steeves3, Wu Zeng4, Marwa Farag3. 1. School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: Mohsen.yaghoubi@usask.ca. 2. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. 3. School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. 4. Wu Zeng, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, United States.
Abstract
OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the effects of pharmacy-based interventions on clinical outcomes associated with diabetes-related complications as well as on nonclinical outcomes in people with diabetes. METHODS: We searched 4 main databases (MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials) for studies that considered clinical and nonclinical outcomes of pharmacy-based interventions among people with diabetes. Clinical outcomes included patients' mean reductions of glycated hemoglobin (A1C) levels and body mass indexes (BMIs). Nonclinical outcomes included patients' healthcare utilization and quality of life. A meta-analysis was conducted to estimate the pooled net mean difference in clinical outcomes between the pharmacy-intervention and the control groups. RESULTS: Of the 44 studies included in the systematic review, 32 studies reported results from randomized controlled trials measuring reductions of A1C levels in 4,132 patients. Meta-analysis revealed that the standardized absolute mean difference in reduction of A1C levels from baseline to the time of the last follow up significantly favoured the pharmacy intervention versus the control group (0.96%; 95% CI 0.71 to 1.22; p<0.001). Of the studies, 13 reported BMI kg/m2 in 1,827 patients. The estimation of standardized absolute mean difference in reduction of BMI unit calculated through meta-analysis was 0.61 (95% CI 0.20 to 1.03; p=0.000) in favour of the pharmacy-intervention group. CONCLUSIONS: Pharmacy-based interventions have significant positive effects on controlling 2 major risks factors associated with diabetes-related complications: A1C levels and BMI. However, there is a dearth of evidence about the effects of pharmacy-based intervention on nonclinical outcomes, including healthcare utilization and quality of life.
OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the effects of pharmacy-based interventions on clinical outcomes associated with diabetes-related complications as well as on nonclinical outcomes in people with diabetes. METHODS: We searched 4 main databases (MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials) for studies that considered clinical and nonclinical outcomes of pharmacy-based interventions among people with diabetes. Clinical outcomes included patients' mean reductions of glycated hemoglobin (A1C) levels and body mass indexes (BMIs). Nonclinical outcomes included patients' healthcare utilization and quality of life. A meta-analysis was conducted to estimate the pooled net mean difference in clinical outcomes between the pharmacy-intervention and the control groups. RESULTS: Of the 44 studies included in the systematic review, 32 studies reported results from randomized controlled trials measuring reductions of A1C levels in 4,132 patients. Meta-analysis revealed that the standardized absolute mean difference in reduction of A1C levels from baseline to the time of the last follow up significantly favoured the pharmacy intervention versus the control group (0.96%; 95% CI 0.71 to 1.22; p<0.001). Of the studies, 13 reported BMI kg/m2 in 1,827 patients. The estimation of standardized absolute mean difference in reduction of BMI unit calculated through meta-analysis was 0.61 (95% CI 0.20 to 1.03; p=0.000) in favour of the pharmacy-intervention group. CONCLUSIONS: Pharmacy-based interventions have significant positive effects on controlling 2 major risks factors associated with diabetes-related complications: A1C levels and BMI. However, there is a dearth of evidence about the effects of pharmacy-based intervention on nonclinical outcomes, including healthcare utilization and quality of life.
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: R Varas-Doval; L Saéz-Benito; M A Gastelurrutia; S I Benrimoj; V Garcia-Cardenas; F Martinez-Martínez Journal: BMC Health Serv Res Date: 2021-02-17 Impact factor: 2.655
Authors: Jennifer Valeska Elli Brown; Nick Walton; Nicholas Meader; Adam Todd; Lisa Ad Webster; Rachel Steele; Stephanie J Sampson; Rachel Churchill; Dean McMillan; Simon Gilbody; David Ekers Journal: Cochrane Database Syst Rev Date: 2019-12-23