Assessing pharmacist's intervention in supporting the management of Type 2 diabetes in a primary care setting.
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SOORAPAN, S. 2002. Assessing pharmacist's intervention in supporting the management of Type 2 diabetes in a primary care setting. Robert Gordon University, PhD thesis.
Type 2 diabetes mellitus is a chronic disease that is associated with substantial morbidity, mortality, and health care cost. All patients with diabetes require a high level of clinical care to prevent the development of diabetic complications. The aim of this study was to compare the impact of a pharmaceutical care diabetic clinic within a primary care setting to standard care on clinical, humanistic and process outcomes in Type 2 diabetes patients. A randomised controlled trial was conducted in 9 general practices in Greater Glasgow Health Board. All patients with Type 2 diabetes, aged 18 years or over, taking an oral antidiabetic drug were recruited and stratified by practice, age, and gender, and then randomised into an active or control group. The patients in both groups were invited to a pharmaceutical care diabetic clinic within their general practice for three visits at three-monthly intervals. Active patients received review and allocated intervention by the pharmacist while control patients received review only without intervention by the pharmacist. Allocation remained blind until after the first evaluation. The pharmacist evaluated the appropriateness of the medication for the individual and their overall diabetic care. The pharmacist prepared a list of drug-related problems and a referral where appropriate. GP referrals were actioned in the active group but held back until after the conclusion of the study in the control group. Patient outcome measures include changes in HbA 1 c value, systolic blood pressure, health related quality of life (HRQOL), and drug related problems (DRPs) from baseline to the end of the study for both groups.