EXPLORING THE ROLE OF CLINICAL PHARMACIST INTERVENTION ON THE OUTCOMES OF PATIENTS WITH TYPE 2 DIABETES MELLITUS
Zheen Aorahman Ahmed a, Zhwan Azad Abdallah b, and Tavga Ahmed Aziz b
a Department of Pharmacology & Toxicolog, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq.
b Department of Clinical Pharmacy, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq.
Submitted: 6/2/2020; Accepted: 1/12/2020; Published: 21/12/2020
DOI Link: https://doi.org/10.17656/jsmc.10280
Diabetes mellitus has been commonly identified as a metabolic disorder characterized by hyperglycemia that occurs as a result of insulin secretion deficiencies, insulin action, or both. It is the fourth largest cause of death, researches aimed to define and compare the views of pharmacists of type 2 diabetes mellitus about causes and methods that improves quality of life and consistency to medication. In order to obtain better therapeutic outcomes by decreasing medicine-related issues it needs to work closely with the patient in implementing and tracking therapeutic plans.
The present study was aimed to evaluate the role of clinical pharmacist interventions in improving the outcome of patients with type 2 diabetes mellitus.
The study was conducted between December 2018 to April 2019 at the Center of Diabetes and Endocrine disease, Directory of Health/ Sulaimani city. One hundred and twenty patients with type 2 diabetes mellitus were randomly divided into two groups: Conventional group that received the usual care and interventional group that received the clinical pharmacist intervention including patient education on life style modification and general guidance on drug therapy that aimed to improve patients’ quality of life and decrease the cost on the diabetic center. Blood sample collected from each patient at zero time and after 90 days of measuring fasting blood glucose, glycosylated hemoglobin and insulin level.
Clinical pharmacist intervention resulted in a significant decrease in body weight, waist circumference and body mass index with no significant change in visceral adiposity index after three months intervention compared to baseline value. It also significantly decreased fasting blood glucose, glycosylated hemoglobin, serum insulin level, and insulin resistance when compared with the baseline value and the conventional group at the end of the study. The interventional group showed reduction in frequency of negative impacts of diabetes mellitus when compared to the baseline value and the conventional group, the intervention also resulted in decreased the cost on the diabetic center.
The implementation of diabetic self-care intervention by the pharmacist was effective in improving glycemic status, and body weight. The intervention also caused reduction in frequency of negative impacts of diabetes mellitus eventually initiated reduction in the overall healthcare cost of diabetic patients compared to patients received usual care.
Type 2 Diabetes mellitus; Clinical pharmacist intervention; Glycemic status; Quality of life; Cost-effectiveness.
1. Koopmanschap M. Coping with Type 11 diabetes: the patient’s perspective. Diabetologia. 2002 Jul;45(7):S18-22.
2. Kaku K. Pathophysiology of Type 2 Diabetes and Its Treatment Policy. JMAJ. 2010; 53(1): 41–46.
3. Abuissa H, Bell DSH, O’Keefe JH. Strategies to prevent type 2 diabetes. Curr Med Res Opin. 2005 Jul 15;21(7):1107–14.
4. FernandeS FlÁVio SilVa ellen, maria mendeS Ferreira criStiane, de Pinho lucineia, Ruy Braga A. Risk factoRs and complications in type 2 diabetes outpatients reV assoc med. Bras. 2017;63(7):621–7.
5. Contreras F, Sanchez M,Martinez MS, Castillo MC,Mindiola A et al. Management and Education in Patients with Diabetes Mellitus. Med Clin Rev. 2017;3(2):7.
6. Hughes J, Wibowo Y, Sunderland B, Hoti K. The role of the pharmacist in the management of type 2 diabetes: current insights and future directions. Integr Pharm Res Pract. 2017; 6:15–27.
7. García-Pérez LE, Álvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013;4(2):175–94.
8. Helper CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–543.
9. Azhar S, Hassali MA, Ibrahim MIM, Ahmad M, Masood I, Shafie AA. The role of pharmacists in developing countries: The current scenario in Pakistan. Hum Resour Health. 2009;7:1–6.
10. Lindenmeyer A, Hearnshaw H, Vermeire E, Van Royen P, Wens J, Biot Y. Interventions to improve adherence to medication in people with type 2 diabetes mellitus: A review of the literature on the role of pharmacists. J Clin Pharm Ther. 2006;31(5):409–19.
11. Franz MJ, Boucher JL, Rutten-Ramos S, VanWormer JJ. Lifestyle Weight-Loss Intervention Outcomes in Overweight and Obese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Acad Nutr Diet. 2015 Sep 1;115(9):1447–63.
12. Muñoz B, O’Leary M, Fonseca-Becker F, Rosario E, Burguess I, Aguilar M, et al. Knowledge of diabetic eye disease and vision care guidelines among hispanic individuals in Baltimore with and without diabetes. Arch Ophthalmol. 2008 Jul;126(7):968–74.
13. Younis N, Broadbent DM, Harding SP, Vora JP. Prevalence of diabetic eye disease in patients entering a systematic primary care-based eye screening programme. Diabet Med. 2002;19(12):1014–21.
14. Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: Rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. American Journal of Clinical Nutrition. 2004; 80: 257–63.
15. Thomas E. Burroughs, Radhika Desikan, Brian Waterman, Debra Gilin, Janet B. McGill Development and Validation of the Diabetes Quality of Life Brief Clinical Inventory . Diabetes Spectrum 2004 ; 17(1): 41-49.
16. Jamshed SQ, Siddiqui MJ, Rana B, Bhagavathula AS. Evaluation of the Involvement of Pharmacists in Diabetes Self-Care: A Review From the Economic Perspective. Front Public Heal. 2018 Sep 3;6.
17. DeGeeter M, Taylor SR, Okarlton EI, Ellex J, Dolder C. Results of a Pharmacist Intervention on Weight Parameters and A1c Compared to Standard Patient Care. J Pharm Technol. 2018 Oct 1;34(5):194–8.
18. Lebovitz HE, Banerji MA. Point: Visceral adiposity is causally related to insulin resistance. Diabetes Care. 2005; 28: 2322–5.
19. Edelman D, Fredrickson SK, Melnyk SD, Coffman CJ, Jeffreys AS, Datta S, et al. Medical clinics versus usual care for patients with both diabetes and hypertension: A randomized trial. Ann Intern Med. 2010 Jun 1;152(11):689–96.
20. Jeong S, Lee M, Ji E. Effect of pharmaceutical care interventions on glycemic control in patients with diabetes: A systematic review and meta-analysis. Ther Clin Risk Manag. 2018;14:1813–29.
21. Javedh Shareef, Jennifer Fernandes, Laxminarayana Samaga. Impact of pharmacist’s intervention on improving quality of life in patients with diabetes mellitus. Journal of Diabetes.Metabolic Disorders & Control. 2016 ; 3 :
© The Authors, published by University of Sulaimani, College of Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.