Effectiveness of a community pharmacist intervention in diabetes care: a randomized controlled trial: Effectiveness of a pharmacist intervention in diabetes care
Open accessAbstract
WHAT IS KNOWN AND OBJECTIVE: There is little evidence from well-designed randomized controlled trials of the impact of community pharmacist intervention on the clinical management of patients with type 2 diabetes. It is also not known how sustainable any observed effects on glycaemic control are, over time. This study was initiated to address both these issues. METHODS: A 6-month, randomized, controlled parallel-group trial in 66 community pharmacies was conducted in Belgium. Patients were randomly assigned to receive usual pharmacist care (n = 135) or a predefined pharmacist intervention (n = 153). The intervention mainly focused on correct medication use, medication adherence and healthy lifestyle promotion. Primary outcome was glycaemic control, as measured by fasting plasma glucose and HbA1c. Sustainability of changes in glycaemic control was assessed by additional glucose measurements 18 months after the end of the study. RESULTS AND DISCUSSION: The intervention significantly reduced HbA1c (between-group difference: 0·5%, P = 0.009). The largest impact on HbA1c was observed when pharmacotherapy changes (i.e., type and/or dose of hypoglycaemic agents) initiated by the physician were sustained with pharmaceutical care: HbA1c was reduced by 1·05% in the intervention group, whose medication was changed, compared with a reduction of 0·02% in the therapy-modification only, group. It was also found that the diabetes education program resulted in improved self-management and better knowledge of diabetes. Eighteen months after the end of the formal study period, the mean HbA1c of the intervention group did not differ significantly from the control group (7·4% vs. 7·2%). WHAT IS NEW AND CONCLUSION: This study provides new evidence, from a randomized controlled trial, of the beneficial effect of community pharmacist intervention in the clinical management of type 2 diabetic patients. However, questions remain about the sustainability of the observed improvements.
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Seventeen studies targeting diabetes reported mean changes in HbA1c, with seven reporting significant improvements in the intervention compared with usual care.
“Seventeen studies targeting diabetes reported mean changes in HbA1c, with seven reporting significant improvements in the intervention compared to usual care”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [52]
There were significant between-study group differences in the domains physical exercise (p = 0.045) and foot care (p<0.001), but the between-group difference for specific diet was non-significant.
“There were significant between-study group differences in the domains ‘physical exercise’ (p = 0.045) and ‘foot care’ (p<0.001), however the between-group difference for ‘specific diet’ were non-significant”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [52]
Self-care activities within 7 days were measured in 4 RCTs using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire.
“Self-care activities within 7 days were measured in 4 RCTs [41, 52, 54, 60, 102, 103] using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [52]
Nine studies reported disease knowledge as an outcome.
“Nine studies reported disease knowledge as an outcome [52, 66–68, 71, 81, 82, 88, 93, 111].”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [52]
Mehuys et al. reported significant improvements in self-management activities in the domains of specific diet (+0.5 day/week, p = 0.008), physical exercise (+0.4 day/week, p = 0.006), and foot care (+1.0 day/week, p<0.001) for intervention patients.
“Mehuys et al. reported significant improvements in self-management activities in the domains of ‘specific diet’ (+0.5 day/week, p = 0.008), ‘physical exercise’ (+0.4 day/week, p = 0.006), and ‘foot care’ (+1.0 day/week, p<0.001) for intervention patients.”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [52]
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- Authors
- Mehuys, E., Van Bortel, L., De Bolle, L., Van Tongelen, I., Annemans, L., Remon, J.-P., & Giri, M.
- Affiliations
- Ghent University (BE)
- Ghent University Hospital (BE)
- Venue
- Journal of Clinical Pharmacy and Therapeutics
- Publisher
- Wiley
- Published
- 2010-12-08
- Volume
- 36
- Issue
- 5
- Pages
- 602-613
- ISSN
- 0269-4727 (ISSN-L)
- OpenAlex
- W1907109187
- Cited by
- 139
- References
- 21
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 3 · 2023: 5 · 2022: 8 · 2021: 11 · 2020: 14 · 2019: 15 · 2018: 15 · 2017: 9 · 2016: 8 · 2015: 15 · 2014: 11 · 2013: 9 · 2012: 5
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Pharmacy and Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Funders
- American Diabetes Association
- Universiteit Gent
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- type 2 diabetes, community pharmacy, pharmacist intervention, pharmaceutical care, glycemic control, HbA1c, medication adherence, medication use, antidiabetic drugs, diabetes education, self-management, healthy lifestyle promotion
- MeSH terms
- Adult, Aged, Aged, 80 and over, Belgium, Blood Glucose, Community Pharmacy Services, Diabetes Mellitus, Type 2, Female, Health Services Research, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Life Style, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Pharmacies, Pharmacists, Drug Prescriptions, Self Care, Time Factors, Treatment Outcome, Disease Management, Medication Adherence
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