Impact of community pharmacy diabetes monitoring and education programme on diabetes management: a randomized controlled study |
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Authors: | Ali M Schifano F Robinson P Phillips G Doherty L Melnick P Laming L Sinclair A Dhillon S |
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Affiliation: | School of Pharmacy, University of Hertfordshire, Hatfield Merck Sharp and Dohme Ltd, Hoddesdon Manor Pharmacy Group, Hertfordshire Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire, Luton, UK. |
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Abstract: | Diabet. Med. 29, e326-e333 (2012) ABSTRACT: Aims To evaluate the impact of a pharmacist-led patient education and diabetes monitoring programme on HbA(1c) and other cardiovascular risk factors in the community setting. Methods Patients with Type?2 diabetes (n?=?46) attending two community pharmacies in Hertfordshire, UK were randomized to one of two groups. Patients in the intervention group (n?=?23) received a programme of education about diabetes, its treatment and associated cardiovascular risk factors. These patients were seen for monitoring/counselling by a community pharmacist on six occasions over a 12-month period. Measures included HbA(1c) , BMI, blood pressure, blood glucose and lipid profile. Patients in the control group (n?=?23) underwent these measurements at baseline and at 12?months only, without specific counselling or education over and above usual care. Results HbA(1c) fell from 66?mmol/mol (8.2%) to 49?mmol/mol (6.6%) (P?0.001) in intervention group, compared with reduction from 65?mmol/mol (8.1%) to 59?mmol/mol (7.5%) in the control group (P?=?0.03). Blood pressure fell from 146/87 to 126/81?mmHg in the intervention group (P?=?0.01) compared with no significant change in the control group (136/86 to 139/82?mmHg). Significant reductions in BMI (30.8 to 27?kg/m(2) , P?0.001) and blood glucose (8.8 to 6.9?mmol/l, P?0.001) were also observed in the intervention group as compared with no significant changes in the control group. Lipid profile changes were mixed. In the intervention group, improvements were seen in diabetes-related quality of life (P?=?0.001), diabetes knowledge (P?=?0.018), belief about the need for medication (P?=?0.004) and reduced concerns regarding medication (P?0.001). Conclusions Education and counselling by community pharmacists can result in favourable improvements to the cardiovascular risk profile of patients with Type?2 diabetes. |
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