Glycemic Control and Management in Pharmacist-Led Diabetic Clinic vs. Physician-Led Diabetic Clinic
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
- Al Dawish, M.A.; Robert, A.A.; Braham, R.; Al Hayek, A.A.; Al Saeed, A.; Ahmed, R.A.; Al Sabaan, F.S. Diabetes mellitus in saudi arabia: A review of the recent literature. Curr. Diabetes Rev. 2016, 12, 359–368. [Google Scholar] [CrossRef] [PubMed]
- Alotaibi, A.; Perry, L.; Gholizadeh, L.; Al-Ganmi, A. Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An overview. J. Epidemiol. Glob. Health 2017, 7, 211–218. [Google Scholar] [CrossRef] [PubMed]
- American Diabetes Association. 9. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes-2020. Diabetes Care 2020, 43, S98–S110. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alsuwayni, B.; Alhossan, A. Impact of clinical pharmacist-led diabetes management clinic on health outcomes at an academic hospital in Riyadh, Saudi Arabia: A prospective cohort study. Saudi Pharm. J. 2020, 28, 1756–1759. [Google Scholar] [CrossRef] [PubMed]
- Stuhec, M.; Gorenc, K.; Zelko, E. Evaluation of a collaborative care approach between general practitioners and clinical pharmacists in primary care community settings in elderly patients on polypharmacy in Slovenia: A cohort retrospective study reveals positive evidence for implementation. BMC Health Serv. Res. 2019, 19, 118. [Google Scholar] [CrossRef] [PubMed]
- Pousinho, S.; Morgado, M.; Falcão, A.; Alves, G. Pharmacist interventions in the management of type 2 diabetes mellitus: A systematic review of randomized controlled trials. J. Manag. Care Spec. Pharm. 2016, 22, 493–515. [Google Scholar] [CrossRef] [PubMed]
- Simpson, S.H.; Majumdar, S.R.; Tsuyuki, R.T.; Lewanczuk, R.Z.; Spooner, R.; Johnson, J.A. Effect of adding pharmacists to primary care teams on blood pressure control in patients with type 2 diabetes: A randomized controlled trial. Diabetes Care 2011, 34, 20–26. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tilton, J.J.; Edakkunnathu, M.G.; Moran, K.M.; Markel Vaysman, A.; DaPisa, J.L.; Goen, B.M.; Touchette, D.R. Impact of a medication therapy management clinic on glycosylated hemoglobin, blood pressure, and resource utilization. Ann. Pharmacother. 2019, 53, 13–20. [Google Scholar] [CrossRef]
- van Eikenhorst, L.; Taxis, K.; van Dijk, L.; de Gier, H. Pharmacist-led self-management interventions to improve diabetes outcomes. a systematic literature review and meta-analysis. Front. Pharmacol. 2017, 8, 891. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Injection Techniques Questionnaire (ITQ) WorldWide Results Fitter for Diabetes. Published 2015. Available online: https://www.fitter4diabetes.com/library/DescriptiveStats.pdf (accessed on 25 May 2021).
- AlJohani, K.A.; Kendall, G.E.; Snider, P.D. Psychometric evaluation of the summary of diabetes self-care activities-arabic (SDSCA-Arabic): Translation and analysis process. J. Transcult. Nurs. 2016, 27, 65–72. [Google Scholar] [CrossRef] [PubMed]
- Toobert, D.J.; Hampson, S.E.; Glasgow, R.E. The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care 2000, 23, 943–950. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Schultz, J.L.; Horner, K.E.; McDanel, D.L.; Miller, M.L.; Beranek, R.L.; Jacobsen, R.B.; Sly, N.J.; Miller, A.C.; Mascardo, L.A. Comparing clinical outcomes of a pharmacist-managed diabetes clinic to usual physician-based care. J. Pharm. Pract. 2018, 31, 268–271. [Google Scholar] [CrossRef] [PubMed]
- Benedict, A.W.; Spence, M.M.; Sie, J.L.; Chin, H.A.; Ngo, C.D.; Salmingo, J.F.; Vidaurreta, A.T.; Rashid, N. Evaluation of a pharmacist-managed diabetes program in a primary care setting within an integrated health care system. J. Manag. Care Spec. Pharm. 2018, 24, 114–122. [Google Scholar] [CrossRef] [PubMed]
- Chung, N.; Rascati, K.; Lopez, D.; Jokerst, J.; Garza, A. Impact of a clinical pharmacy program on changes in hemoglobin A1c, diabetes-related hospitalizations, and diabetes-related emergency department visits for patients with diabetes in an underserved population. J. Manag. Care Spec. Pharm. 2014, 20, 914–919. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Characteristic | Pharmacist-Led Diabetic Clinics n = 24 | Physician-Led Diabetic Clinics n = 28 | p-Value * |
---|---|---|---|
Sex | 0.16 | ||
Male | 7 (29.2%) | 14 (50%) | |
Female | 17 (70.8%) | 14 (50%) | |
Age (Years), (median, IQR) | 63.5 (8.5) | 63 (19.5) | 0.81 |
DM Type | 1 | ||
1 | 1 (4.2%) | 2 (7.1%) | |
2 | 23 (95.8%) | 26 (92.9%) | |
Average BMI Classification | 1 | ||
Below 18.5 underweight | 0 | 0 | |
18.5–24.9 normal | 3 (12.5%) | 4 (14.3%) | |
25–29.9 Over weight | 8 (33.3%) | 9 (32.1%) | |
Over 30 Obesity | 13 (54.2%) | 15 (53.6%) | |
Baseline Lipid Panel | |||
LDL (mean, SD) | 2.2 ± 0.76 | 2.11 ± 0.81 | 0.68 |
Cholesterol (median, IQR) | 4.27 (0.88) | 3.83 (1.33) | 0.51 |
HDL (median, IQR) | 1.15 (0.5) | 1.2 (0.28) | 0.88 |
Triglyceride (mean, SD) | 1.56 ± 0.96 | 1.44 ± 0.59 | 0.5 |
Baseline HbA1c (median, IQR) | 8.7 (2.28) | 8.4 (1.58) | 0.47 |
Baseline FBG (Mean, SD) | 10.37 ± 4.35 | 8.93 ± 4.23 | 0.18 |
Comorbidity + | |||
Dyslipidemia | 16 | 4 | |
HTN | 18 | 19 | |
Hypo-Hyperthyroidism | 5 | 2 | |
Cardiac Patient | 3 | 2 | |
Other ^ | 17 | 13 | |
Baseline BP | |||
SBP (Mean, SD) | 132.25 ± 16.62 | 134.17 ± 20.28 | 0.63 |
DBP (Mean, SD) | 71.66 ± 14.75 | 75.43 ± 16.75 | 0.3 |
Social Demographics | Pharmacist-Led Diabetic Clinics n = 17 | Physician-Led Diabetic Clinics n = 18 | p-Value |
---|---|---|---|
Social Status n = 35 (17 Patients Refused to Participate) | 0.69 | ||
Single | 4 | 3 | |
Married | 13 | 15 | |
Education Level n = 35 (17 Patients Refused to Participate) | 0.59 | ||
Uneducated | 3 | 0 | |
Primary School | 1 | 1 | |
Intermediate School | 2 | 3 | |
Secondary School | 2 | 1 | |
University | 5 | 5 | |
Postgraduate education | 4 | 8 | |
Family Monthly Income n = 35 (17 Patients Refused to Participate) | 0.54 | ||
Less than 4000 SR | 2 | 0 | |
From 4000 to 8000 SR | 2 | 3 | |
From 8000 to 15,000 SR | 6 | 4 | |
From 15,000 to 23,000 SR | 2 | 6 | |
More than 23,000 SR | 5 | 5 | |
Number of Family Members n = 35 (17 Patients Refused to participate) | 0.44 | ||
0–2 | 1 | 2 | |
3–4 | 1 | 3 | |
5–6 | 8 | 4 | |
More than 6 | 7 | 9 |
Characteristics | Pharmacist-Led Diabetic Clinics n = 24 | Physician-Led Diabetic Clinics n = 28 | p-Value |
---|---|---|---|
Number of Visits (Median, IQR) | 5 (1.8) | 3 (2) | 0.0005 |
Number of Visits | 0.0005 | ||
2–3 | 3 (12.5%) | 18 (64.3%) | |
4–6 | 17 (70.8%) | 10 (35.7%) | |
More than 6 | 4 (16.7%) | 0 | |
Average Lipid Panel | |||
LDL (median, IQR) | 2.41 (1.4) | 2.07 (0.63) | 0.24 |
Cholesterol (median, IQR) | 4.43 (1.47) | 3.97 (0.84) | 0.11 |
HDL (mean, SD) | 1.28 ± 0.51 | 1.19 ± 0.4 | 0.39 |
Triglyceride (median, IQR) | 1.65 (1.19) | 1.38 (0.84) | 0.42 |
Average HbA1c (median, IQR) | 8.67 (1.45) | 8.56 (1.82) | 0.77 |
Average FBG (median, IQR) | 9.51 (3.57) | 9.14 (3.18) | 0.53 |
Average BP | |||
SBP (Mean, SD) | 134.63 ± 10.06 | 136.38 ± 15.51 | 0.64 |
DBP (Mean, SD) | 71.64 ± 7.8 | 75.45 ± 9.65 | 0.13 |
Number of Changed Doses per Patient | Pharmacist-Led Clinics | Physician-Led Clinics | Total |
---|---|---|---|
0 | 3 | 7 | 10 |
1 | 6 | 10 | 16 |
2 | 4 | 10 | 14 |
3 | 1 | 1 | 2 |
4 | 4 | 0 | 4 |
5 | 4 | 0 | 4 |
6 | 1 | 0 | 1 |
7 | 1 | 0 | 1 |
Total | 24 | 28 | 52 |
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Alghadeer, S.M.; Alsuwayni, B.; Almuwayjid, A.K.; Almadi, M.S.; Mubarak, A.M.; Khunayn, R.M.b.; Al-Arifi, M.N. Glycemic Control and Management in Pharmacist-Led Diabetic Clinic vs. Physician-Led Diabetic Clinic. Medicina 2022, 58, 14. https://doi.org/10.3390/medicina58010014
Alghadeer SM, Alsuwayni B, Almuwayjid AK, Almadi MS, Mubarak AM, Khunayn RMb, Al-Arifi MN. Glycemic Control and Management in Pharmacist-Led Diabetic Clinic vs. Physician-Led Diabetic Clinic. Medicina. 2022; 58(1):14. https://doi.org/10.3390/medicina58010014
Chicago/Turabian StyleAlghadeer, Sultan M., Bashayr Alsuwayni, Abdulmohsen K. Almuwayjid, Mohammed S. Almadi, Abdullah M. Mubarak, Rawan M. bin Khunayn, and Mohamed N. Al-Arifi. 2022. "Glycemic Control and Management in Pharmacist-Led Diabetic Clinic vs. Physician-Led Diabetic Clinic" Medicina 58, no. 1: 14. https://doi.org/10.3390/medicina58010014