Abstract
Objective To evaluate the effectiveness of pharmaceutical care services in management teams by assessing the change in hemoglobin A1c (A1C), cholesterol, and blood pressure for patients with type 2 diabetes in a diabetes ward. Setting Tongde hospital of Zhejiang province, a 1,200 bed South China teaching hospital, serving the local community. Method A single-center, 2-phase (pre-/postintervention phase) designs was performed. Patients in postintervention phase (July 2013 to December 2013) received pharmaceutical care from a clinical pharmacist, while patients in the preintervention phase (January 2013 to June 2013) received routine medical care. The pre- and postintervention phases were then compared to evaluate the outcomes of pharmaceutical care services. Main outcome measure The primary end point was the absolute change in A1C versus baseline, the change in cholesterol and blood pressure and the number of patients to achieve Chinese Diabetes Society (CDS) goals at the baseline and at the end of pharmaceutical care were the main outcome measures. Results During the 6-month study period, the postintervention phase showed a greater percent change in A1C (−1.45 vs. −0.43 %, P = 0.03). Another end points for achieving CDS goals were statistically significantly different in low-density lipoprotein, triglycerides and blood pressure. In the phase that received the participation of pharmacists, the number of patients that improved in A1C increased from 327 to 406 (P = 0.02); the number of rehospitalization was 29 for the postintervention phase and 75 for the preintervention phase (P = 0.05).The drug cost per patient day decreased from € 254.74 to € 219.85 (P = 0.095), and the Length of stay (LOS) did not change significantly (16.35 vs. 15.91 days; P = 0.15).Conclusion Including a pharmacist as a part of the diabetes management team may result in lower A1C, cholesterol and blood pressure in patients versus a health care.
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Cauch-Dudek K, Victor JC, Sigmond M, Shah BR. Disparities in attendance at diabetes self-management education programs after diagnosis in Ontario, Canada: a cohort study. BMC Public Health. 2013;13:85–91.
Gregg EW, Gu Q, Cheng YJ, Narayan KM, Cowie CC. Mortality trends in men and women with diabetes, 1971 to 2000. Ann Intern Med. 2007;147:149–55.
Yang WY, Lu JM, Weng JP, Jia W, Ji L, Xiao J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;12:1090–101.
Devlin JW, Bhat S, Roberts RJ, Skrobik Y. Current perceptions and practices surrounding the recognition and treatment of delirium in the intensive care unit: a survey of 250 critical care pharmacists from eight states. Ann Pharmacother. 2011;45:1217–29.
Zhang C, Zhang LL, Huang L, Luo R, Wen J. Clinical pharmacists on medical care of pediatric inpatients: a single-center randomized controlled trial. PLoS ONE. 2012;7:e30856.
MacLaren R, Bond CA, Martin SJ, Fike D. Clinical and economic outcomes of involving pharmacists in the direct care of critically ill patients with infections. Crit Care Med. 2008;36:3184–9.
Al Mazroui NR, Kamal MM, Ghabash NM, Yacout TA, Kole PL, McElnay JC. Influence of pharmaceutical care on health outcomes in patients with Type 2 diabetes mellitus. Br J Clin Pharmacol. 2009;67:547–57.
Cranor CW, Bunting BA, Christensen DB. The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program (Wash). J Am Pharm Assoc. 2003;43:173–84.
Rothman R, Malone R, Bryant B, Horlen C, Pignone M. Pharmacist-led, primary care-based disease management improves hemoglobin A1c in high-risk patients with diabetes. Am J Med Qual. 2003;18:51–8.
Forjuoh SN, Huber C, Bolin JN, Patil SP, Gupta M, Helduser JW, et al. Provision of counseling on diabetes self-management: are there any age disparities? Patient Educ Couns. 2011;85:133–9.
Borges AP, Guidoni CM, Ferreira LD, de Freitas O, Pereira LR. The Pharmaceutical care of patients with type 2 diabetes mellitus. Pharm World Sci. 2010;32:730–6.
Shen J, Sun Q, Zhou X, Wei Y, Qi Y, Zhu J, et al. Pharmacist interventions on antibiotic use in inpatients with respiratory tract infections in a Chinese hospital. Int J Clin Pharm. 2011;33:929–33.
Thomas DR, Ludo WE, Steven S. Economic effects of clinical pharmacy interventions: a literature review. Am J Health Syst Pharm. 2008;65:1161–72.
Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R, et al. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes Metab Res Rev. 2011;27:639–53.
Acknowledgments
We would like to acknowledge Dr Yun-long Tian, Dr Cheng Jiang and Mrs Ting-Xia for their involvement.
Funding
This study was supported by the Medical Association of Zhejiang province (2013ZYC-A08) and Zhejiang provincial natural science foundation (LY14H280003).
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Xin, C., Ge, X., Yang, X. et al. The impact of pharmaceutical care on improving outcomes in patients with type 2 diabetes mellitus from China: a pre- and postintervention study. Int J Clin Pharm 36, 963–968 (2014). https://doi.org/10.1007/s11096-014-9978-x
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DOI: https://doi.org/10.1007/s11096-014-9978-x