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International Journal of Clinical Pharmacy

, Volume 38, Issue 1, pp 88–95 | Cite as

Pharmaceutical care of elderly patients with poorly controlled type 2 diabetes mellitus: a randomized controlled trial

  • Jyun-Hong Chen
  • Huang-Tz Ou
  • Tzu-Chieh Lin
  • Edward Chia-Cheng Lai
  • Yea-Huei Yang Kao
Research Article

Abstract

Background Care of the elderly with diabetes is more complicated than that for other age groups. The elderly and/or those with multiple comorbidities are often excluded from randomized controlled trials of treatments for diabetes. The heterogeneity of health status of the elderly also increases the difficulty in diabetes care; therefore, diabetes care for the elderly should be individualized. Motivated patients educated about diabetes benefit the most from collaborating with a multidisciplinary patient-care team. A pharmacist is an important team member by serving as an educator, coach, healthcare manager, and pharmaceutical care provider. Objective To evaluate the effects of pharmaceutical care on glycemic control of ambulatory elderly patients with type 2 diabetes. Setting A 421-bed district hospital in Nantou City, Taiwan. Method We conducted a randomized controlled clinical trial involving 100 patients with type 2 diabetes with poor glycemic control (HbA1c levels of ≥9.0 %) aged ≥65 years over 6 months. Participants were randomly assigned to a standard-care (control, n = 50) or pharmaceutical-care (intervention, n = 50) group. Pharmaceutical care was provided by a certified diabetes-educator pharmacist who identified and resolved drug-related problems and established a procedure for consultations pertaining to medication. The Mann–Whitney test was used to evaluate nonparametric quantitative data. Statistical significance was defined as P < 0.05. Main outcome measure The change in the mean HbA1c level from the baseline to the next level within 6 months after recruiting. Results Nonparametric data (Mann–Whitney test) showed that the mean HbA1c level significantly decreased (0.83 %) after 6 months for the intervention group compared with an increase of 0.43 % for the control group (P ≤ 0.001). Medical expenses between groups did not significantly differ (−624.06 vs. −418.7, P = 0.767). There was no significant difference in hospitalization rates between groups. Conclusion The pharmacist intervention program provided pharmaceutical services that improved long-term, safe control of blood sugar levels for ambulatory elderly patients with diabetes and did not increase medical expenses.

Keywords

Clinical trials Diabetes Elderly Pharmaceutical care Taiwan 

Notes

Acknowledgments

The authors thank the patients who participated in the study and the physicians, nurses (Huei-Yu Jheng), dietitians, and staff (Ker-Cheng Lin, Su-Mi Chen) at the Nantou Hospital, Ministry of Health and Welfare, Taiwan (ROC).

Funding

This study was supported by a Grant from the Department of Health, Executive Yuan, Taiwan (ROC) (100-MID-08).

Conflicts of interest

No potential conflicts of interest relevant to this article were reported.

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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Jyun-Hong Chen
    • 1
    • 2
    • 3
  • Huang-Tz Ou
    • 3
  • Tzu-Chieh Lin
    • 3
  • Edward Chia-Cheng Lai
    • 3
  • Yea-Huei Yang Kao
    • 3
  1. 1.Department of PharmacyNantou Hospital, Ministry of Health and WelfareNantou CityTaiwan
  2. 2.Isotope Application Division, Institute of Nuclear Energy Research, Atomic Energy CouncilExecutive YuanTaipei CityTaiwan
  3. 3.Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of MedicineNational Cheng Kung UniversityTainan CityTaiwan

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