OBJECTIVEThe aim of this study was to assess the efficacy of a 12-month prevention program conducted in 42 community pharmacies in reducing the risk for diabetes. RESEARCH DESIGN AND METHODSIn a cluster-randomized controlled trial in 1,092 participants, mean change in the risk for diabetes (indicated by the Finnish Diabetes Risk Score [FINDRISC]) between intervention and control groups was calculated. In the intervention program GLICEMIA, three appointments with individual counseling and five educational group sessions were combined, whereas in the control group, only information about the participants' health was obtained in three assessments. RESULTSAfter adjusting for cluster structure and differences in baseline characteristics, improvement in FINDRISC in the intervention group was 0.74 points (95% CI 0.42-1.04) above the control group. CONCLUSIONSThe GLICEMIA program shows the feasibility of a pharmacy-based intervention and leads to a significant modest reduction in diabetes risk score but does not reduce the rate of diabetes progression over 1 year.The prevalence of type 2 diabetes is increasing worldwide (1). As recently published in a meta-analysis, diabetes prevention in the outpatient setting can be effective (2). Community pharmacies could be a suitable site to establish a conveniently accessible diabetes prevention program (3,4). Therefore, the diabetes prevention program GLICEMIA was developed according to international guidelines and requirements of the German statutory health insurances (5-7). The aim of this study was to evaluate the feasibility and effectiveness of the diabetes prevention program GLICEMIA in community pharmacies. RESEARCH DESIGN AND METHODSThe trial is a prospective multicenter cluster-randomized controlled intervention study. The 42 participating community pharmacies in Bavaria, South Germany, were randomly assigned one-to-one to the intervention or to the control group. Pharmacists from each center participated in a 1-day training on how to conduct the study. The intervention pharmacies had an additional 0.5-day training on counseling for behavior changes. Thus, the study was not blinded. The trial started in
Pharmacists are active in many different prevention subjects and there is a great interest in pharmacy-based preventive care counselling in the Bavarian population. Very few structured, well planned and evaluated preventive projects have been conducted in Bavarian community pharmacies. Further surveys are needed to analyse the benefit of pharmacy-based preventive care counselling for the Bavarian population.
With its increasing incidence, diabetes is one of the major challenges of the 21th century. Against this background, the Bavarian State Ministry of Public Health and Care Services (BStMGP) started in 2014 the campaign "Diabetes moves us!". The scientific institute for prevention in health care (WIPIG) supported the activities of Bavarian pharmacies and evaluated the extent to which they might be able to contribute towards prevention. Besides additional training of pharmaceutical staff, WIPIG initiated a diabetes prevention network. Pharmacies that were members of the network had the opportunity to order a campaign package including an evaluation questionnaire and to register their activity in the calendar of events of the campaign. A total of 215 pharmacies signed up for the diabetes prevention network and registered 103 events. The WIPIG received 67 completed evaluation questionnaires. Most often (86.6%) the pharmacies conducted a blood glucose screening; 76.1% carried out screening with the diabetes risk questionnaire FINDRISC of the German Diabetes Foundation and 22.4% gave a information lecture on diabetes. During the screening 2,502 persons had their blood sugar checked and 1,765 persons filled in the FINDRISC questionnaire. Overall, 190 persons were advised to visit their physician because of a very high blood glucose level. On the basis of the FINDRISC, 80.2% were advised to change their lifestyle to prevent type 2 diabetes.
Aufgrund weltweit steigender Erkrankungszahlen kommt der Früherkennung und Prävention von Typ-2-Diabetes eine besondere Bedeutung zu. Trotz zahlreicher Studien hierzu existiert bislang kein flächendeckendes Präventi-onsprogramm. Mit dem FINDRISKFragebogen besteht jedoch die Möglichkeit, Risikopersonen früh-zeitig zu identifizieren und einer Präventionsbetreuung zuzuführen. Auf der Grundlage internationaler Leitlinien wurde daher das Präventi-onsprogramm GLICEMIA entwickelt, welches den FINDRISK als zentrales Risikobewertungsinstrument nutzt. Es wurde nachgewiesen, dass die Teilnahme an diesem Programm zur Reduktion von Risikofaktoren für Typ-2-Diabetes beiträgt.
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