The pharmacy Diabetes Care Program: assessment of a community pharmacy diabetes service model in Australia

Author(s): Krass I, Armour CL, Mitchell B, Brilliant M, Dienaar R, et al.

Abstract

Aim: To assess the impact of a community pharmacy diabetes service model on patient outcomes in Type 2 diabetes.

Methods: The study utilized a multisite, control vs. intervention, repeated-measures design within four states in Australia. Fifty-six community pharmacies, 28 intervention and 28 control, were randomly selected from a representative sample of urban and rural areas. Intervention pharmacies delivered a diabetes service to patients with Type 2 diabetes, which comprised an ongoing cycle of assessment, management and review, provided at regular intervals over 6 months in the pharmacy. These services included support for self monitoring of blood glucose, education, adherence support, and reminders of checks for diabetes complications. Control pharmacists assessed patients at 0 and 6 months and delivered no intervention.

Results: A total of 289 subjects (149 intervention and 140 control) completed the study. For the intervention subjects, the mean blood glucose level decreased over the 6-month study from 9.4 to 8.5 mmol/l (P < 0.01). Furthermore, significantly greater improvements in glycaemic control were seen in the intervention group compared with the control: the mean reduction in HbA(1c) in the intervention group was -0.97% (95% CI: -0.8, -1.14) compared with -0.27% (95% CI: -0.15, -0.39) in the control group. Improvements were also seen in blood pressure control and quality of life in the intervention group.

Conclusion: A pharmacy diabetes service model resulted in significant improvements in clinical and humanistic outcomes. Thus, community pharmacists can contribute significantly to improving care and health outcomes for patients with Type 2 diabetes. Future research should focus on clarifying the most effective elements of the service model.

Similar Articles

National standards for diabetes self-management education

Author(s): Mensing C, Boucher J, Cypress M, Weinger K, Mulcaby K, et al.

The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes

Author(s): Parving HH, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, et al.

Am Fam Phys 55: 817-824

Author(s): Baliga BS, Fonseca VA (l997) Recent advances in the treatment of type II diabetes mellitus

Metformin

Author(s): Bailey CJ, Turner RC

Incidence of lactic acidosis in metformin users

Author(s): Stang M, Wysowski DK, Butler-Jones D

Profiles of people with type 2 diabetes mellitus

Author(s): Savoca MR, Miller CK, Quandt SA

Phenformin-induced lactic acidosis precipitated by tetracycline

Author(s): Arc A, Korhonen T, Halinen M

Br J Clin Pharmacol 23: 545-55 1

Author(s): Somogyi A, Stockley C, Keal J, Rolan P, Bockner F (1 987) Reduction of metformin renal tubular secretion by cimetidine in man

Oral hypoglycemic agents in type II diabetes mellitus

Author(s): Lubbos H, Miller JL, Rose LI

Primary care diabetes

Author(s): Yeap BB

Ann Pharmacother 30: 20-26

Author(s): Kubacka RT, Antal EJ, Juhi RP, Weishman IR (1 996) Effects of aspirin and ibuprofen on the pharmacokinetics and pharmacodynamics of glyburide in healthy subjects

Suiphaphenazole-induced hypoglycaemic attacks in tolbutamide-treated diabetics

Author(s): Christensen LK, Hansen J, Kristensen M

Drug-induced hypoglycemic coma in 102 diabetic patients

Author(s): Ben-Ami H, Nagachandran P, Mendelson A, Edoute Y

Attitudes and beliefs about exercise among persons with non-insulin dependent diabetes

Author(s): Swift CS, Armstrong JE, Berman KA, Cambell RK, Pond-Smith D

Nursing Research: Principle and Methods (7thedn)

Author(s): Polit DF, Hungler BP

The role of self monitoring of blood glucose in the care of people with diabetes: report of global consensus conference

Author(s): Bergenstal RM, Gavin JR, Global Consensus conference on Glucose monitoring panel

Self-monitoring of blood glucose among diabetes patients attending government health clinics

Author(s): Mastura I, Mimi O, Piterman L, Teng CL, Wijesinha S

Ethnicity and glycaemic control are major determinants of diabetic dyslipidaemia in Malaysia

Author(s): Ismail IS, Nazaimoon W, Mohamad W, Letchuman R, Hew FL, et al.

Therapeutic benefits of ACE inhibitors and other antihypertensive drugs in patients with type 2 diabetes

Author(s): Pahor M, Psaty BM, Alderman MH, Applegate WB, Williamson JD, et al.

Using intake biomarkers to evaluate the extent of dietary misreporting in a large sample of adults: the OPEN study

Author(s): Subar AF, Kipnis V, Troiano RP, Midthune D, Schoeller DA, et al.

Nutrition recommendations and interventions for diabetes--2006: a position statement of the American Diabetes Association

Author(s): Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, et al.

The Dietician challenge: the implementation of nutritional advice for people with diabetes

Author(s): Nutrition sub-committee of the diabetes Care Advisory Committee of Diabetes UK

The epidemic of obesity

Author(s): Stein CJ, Colditz GA

Clinic based support to help overweight patients with type 2 diabetes increase physical activity and loss weight

Author(s): Christian JG, Bessesen DH, Byers TE, Christian KK, Goldstein MG, et al.

Self-help weight loss versus a structured commercial program after 26 week: a randomized controlled study

Author(s): Heshka S, Greenway F, Anderson JW, Atkinson RL, Hill JO, et al.

Patient education in the management of diabetes mellitus

Author(s): Tan SL, Yong LS, Wan S, Wong ML

Structured patient education: the diabetes X-PERT programme makes a difference

Author(s): Deakin T, Cade J, Williams R, Greenwood D

A taxanomy of diabetes educational intervention

Author(s): Elasy T, Ellis S, Brown A, Pichert J

Patient adherence improves glycaemic control

Author(s): Rhee MK, Slocum W, Ziemer DC, Culler SD, Cook CB, et al.

Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin

Author(s): Welschen LM, Bloemendal E, Nijpels G, Dekker J, Heine RJ, et al.

Access to transportation and health care utilization in a rural region

Author(s): Arcury TA, Preisser JS, Gesler WM, Powers JM

Driving distance as a barrier to glycaemic control in diabetes

Author(s): Strauss K, MacLean C, Troy A, Littenberg B

The use of text messaging to improve attendance in primary care: a randomized controlled trial

Author(s): Leong KC, Chen WS, Leong KW, Mastura I, Mimi O, et al.