Background Glycaemic goals are often not achieved in patients with type 2 diabetes despite the availability of many effective treatments and the documented benefits of glycaemic control in the reduction of long-term microvascular and macrovascular complications.
Purpose To evaluate, in a randomised, controlled trial, the impact of a clinical pharmacy service on clinical outcomes in patients with type 2 diabetes.
Materials and Methods A total of 171 patients (85 interventions vs. 86 usual care) participated in the study. Intervention patients had individualised education and treatment recommendations from a clinical pharmacist while control patients received usual care provided by the clinic. The primary outcome measure was glycaemic control manifested by HbA1c reductions. All other data collected including systolic and diastolic blood pressure, total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), serum triglycerides, medication adherence, and necessary self-care activities formed secondary outcome measures. Between-group differences in the amounts of change from baseline to 6-month follow-up were tested and a p value of <0.05 was considered statistically significant.
Results Compared with baseline values, patients in the intervention group had a mean reduction of 0.8% in HbA1c versus a mean increase of 0.1% from baseline in the usual care group (P = 0.019). The intervention group compared with the usual care group had small but statistically significant improvements in the secondary measures of fasting blood glucose, systolic and diastolic blood pressure, total cholesterol, LDL, serum triglycerides, self-reported medication adherence and self-care activities. Between-group differences in changes in the secondary measures of HDL and body mass index were not significant.
Conclusions The enhanced patient clinical outcomes as a result of pharmacist-led pharmaceutical care in an outpatient diabetes clinic in the present study demonstrate the value of an enhanced clinical pharmacy service in improving diabetes care and achieving the desired therapeutic outcomes for patients with type 2 diabetes.
No conflict of interest.
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