Pharmacist Interventions May Improve Clinical Outcomes of Patients With T2D
By getting involved in patient care, pharmacists can help alleviate the burdens associated with the self-management of type 2 diabetes (T2D).
Pharmacist interventions can influence the therapeutic effects of several clinical outcomes of patients with type 2 diabetes (T2D), according to a meta-analysis published in Patient Education and Counseling.1
The clinical outcomes that measured significant changes were hemoglobin A1c (HbA1c), blood pressure, high-density lipoprotein cholesterol (LDL-C), body mass index (BMI), and medication adherence. However, no significant changes were measured for low-density lipoprotein cholesterol (HDL-C), triacylglycerol (TG), or total cholesterol (TC).
In collecting and evaluating literature for their meta-analysis, investigators sought to supplement a lack of research on the impact of pharmacist interventions across a broad range of clinical indicators associated with T2D.
Using the keywords “diabetes type 2” and “pharmacists” to search across 6 databases, investigators combed through and selected 35 studies involving 4827 patients for final analysis. Inclusion criteria included randomized controlled trials of pharmacist interventions for patients with T2D, and clinical outcome indicators included HbA1c; LDL-C; HDL-C; systolic blood pressure (SBP); diastolic blood pressure (DBP); fasting blood glucose (FBG); TC; TG; BMI; and medication adherence.
Levels of HbA1c were evaluated in 34 studies, HDL-C in 15 studies, LDL-C in 20 studies, SBP in 23 studies, DBP in 20 studies, BMI in 13 studies, TG in 16 studies, TC in 17 studies, FBG in 9 studies, and medication adherence in 16 studies.
Results demonstrated that the impact of pharmacist interventions led to a significant reduction in HbA1c levels (MD = –0.70, 95% CI = [–0.97, –0.43], P < .00001). A significant change was also measured in LDL-C (MD = –5.51, 95% CI = [–9.08, –1.94], P = .002), SBP (MD = –4.58, 95% CI = [–6.03, –3.13], P < .00001), DBP (MD = –1.90, 95% CI = [–3.81, 0.02], P = .05), BMI (MD = –0.47, 95% CI = [–0.85, –0.10], P = .01), and FBG (MD = –19.82, 95% CI = [–30.27, –9.37], P = .0002).
Out of the 16 studies that measured the clinical indicator, every intervention group demonstrated an improvement in medication adherence.
On the contrary, the meta-analysis did not show a significant reduction in LDL-C (MD = –5.51, 95% CI = [–9.08, –1.94], P = .002), TC, (MD = –5.12, 95% CI = [15.93, 5.68], P = .35), or TG (MD = –3.14, 95% CI = [–11.54, 5.26], P = .46).
Diabetes is a chronic condition that requires ongoing management, and as such demands a high degree of self-management from patients. Challenges associated with the nature of the disease, like high costs, medication adherence, and a susceptibility to complications, further complicate self-management of the condition. With their knowledge and skills in medication education, consultation, and supervision, pharmacists can help alleviate the burdens associated with the self-management of T2D and improve health outcomes among patients.
“Our study shows that pharmacist interventions play an active role in clinical outcomes in patients with T2D,” said study authors. “The characteristics of a long treatment cycle, high cost, insufficient patient compliance, and easy complications make pharmacist interventions more practical.”
