A Community-Based Pilot Study of a Diabetes Pharmacist Intervention in Latinos: Impact on Weight and Hemoglobin A1c

Abstract

Type 2 diabetes disproportionately affects Latinos increasing their risk of diabetes-related complications. This study used a randomized controlled design with a community-based approach to evaluate the impact of a culturally tailored pharmacist intervention on clinical outcomes in Latino diabetics. The intervention included a focused discussion and two individual pharmacist counseling sessions on medication, nutrition, exercise, and self-care to promote behavior changes. Sessions were culturally adapted for language, diet, family participation, and cultural beliefs. Clinical outcomes were measured at baseline and three months. Nineteen intervention and 24 control participants completed the study. Mean BMI reduction was greater for intervention than for control group participants (-0.73 ± 0.07 kg/m2 versus + 0.37 ± 0.02 kg/m2 p<.009 respectively). Hemoglobin A1c was significantly reduced by 0.93 ± 0.45% in the intervention group only. There was no significant difference in blood glucose, blood pressure, or lipid levels. An innovative culturally-sensitive pharmacist intervention improved selected clinical outcomes among Latino diabetics.

Efficacy of Pharmacist Based Diabetes Educational Interventions on Clinical Outcomes of Adults With Type 2 Diabetes Mellitus: A Network Meta-Analysis

“…Among the studies included in this review, n = 3 were cluster-randomized controlled trials, (Armour et al, 2004; Krass et al, 2007; Mehuys et al, 2011) whereas rest of the studies, n = 40 were parallel randomized controlled trials (Sarkadi and Rosenqvist, 2004; Clifford et al, 2005; Hayward et al, 2005; Odegard et al, 2005; Rothman et al, 2005; Suppapitiporn et al, 2005; Taylor et al, 2005; Fornos et al, 2006; Scott et al, 2006; Ko et al, 2007; Al Mazroui et al, 2009; Doucette et al, 2009; Jameson and Baty, 2010; Kang et al, 2010; Taveira et al, 2010; Cohen et al, 2011; Farsaei et al, 2011; Sriram et al, 2011; Ali et al, 2012; Chan et al, 2012; Jacobs et al, 2012; Jarab et al, 2012; Mahwi and Obied, 2013; Mourão et al, 2013; Samtia et al, 2013; Castejón et al, 2014; Chung et al, 2014; Ahmad et al, 2015; Cani et al, 2015; Chow et al, 2015; Jahangard-Rafsanjani et al, 2015; Wishah et al, 2015; Butt et al, 2016; Chen et al, 2016; Lim et al, 2016; Nascimentoa et al, 2016; Tourkmani et al, 2016; Korcegez et al, 2017; Shao et al, 2017; Siaw et al, 2017). Most of the included studies ( n = 20) were conducted in Asia (Suppapitiporn et al, 2005; Ko et al, 2007; Kang et al, 2010; Farsaei et al, 2011; Sriram et al, 2011; Chan et al, 2012; Jarab et al, 2012; Mahwi and Obied, 2013; Samtia et al, 2013; Chung et al, 2014; Chow et al, 2015; Jahangard-Rafsanjani et al, 2015; Wishah et al, 2015; Butt et al, 2016; Chen et al, 2016; Lim et al, 2016; Tourkmani et al, 2016; Shao et al, 2017; Siaw et al, 2017), followed by North America ( n = 11) (Hayward et al, 2005; Odegard et al, 2005; Rothman et al, 2005; Scott et al, 2006; Doucette et al, …”

“…Most of the included studies ( n = 20) were conducted in Asia (Suppapitiporn et al, 2005; Ko et al, 2007; Kang et al, 2010; Farsaei et al, 2011; Sriram et al, 2011; Chan et al, 2012; Jarab et al, 2012; Mahwi and Obied, 2013; Samtia et al, 2013; Chung et al, 2014; Chow et al, 2015; Jahangard-Rafsanjani et al, 2015; Wishah et al, 2015; Butt et al, 2016; Chen et al, 2016; Lim et al, 2016; Tourkmani et al, 2016; Shao et al, 2017; Siaw et al, 2017), followed by North America ( n = 11) (Hayward et al, 2005; Odegard et al, 2005; Rothman et al, 2005; Scott et al, 2006; Doucette et al, 2009; Jameson and Baty, 2010; Taveira et al, 2010; Cohen et al, 2011; Jacobs et al, 2012; Castejón et al, 2014; Korcegez et al, 2017), Europe ( n = 5) (Sarkadi and Rosenqvist, 2004; Fornos et al, 2006; Mehuys et al, 2011; Ali et al, 2012; Nascimentoa et al, 2016), Australia ( n = 4) (Armour et al, 2004; Clifford et al, 2005; Taylor et al, 2005; Krass et al, 2007), South America ( n = 2) (Mourão et al, 2013; Cani et al, 2015), and Africa ( n = 1) (Ahmad et al, 2015). …”

“…Seven studies has duration of intervention was < 6 months (Taveira et al, 2010; Farsaei et al, 2011; Mahwi and Obied, 2013; Samtia et al, 2013; Castejón et al, 2014; Jahangard-Rafsanjani et al, 2015; Lim et al, 2016) 14 studies had 6 months (Hayward et al, 2005; Krass et al, 2007; Cohen et al, 2011; Mehuys et al, 2011; Jarab et al, 2012; Mourão et al, 2013; Ahmad et al, 2015; Cani et al, 2015; Chow et al, 2015; Wishah et al, 2015; Chen et al, 2016; Nascimentoa et al, 2016; Shao et al, 2017; Siaw et al, 2017) and 22 studies' duration of intervention was more than 6 months (Armour et al, 2004; Sarkadi and Rosenqvist, 2004; Clifford et al, 2005; Odegard et al, 2005; Rothman et al, 2005; Taylor et al, 2005; Fornos et al, 2006; Scott et al, 2006; Ko et al, 2007; Johnson et al, 2008; Al Mazroui et al, 2009; Doucette et al, 2009; Jameson and Baty, 2010; Kang et al, 2010; Cohen et al, 2011; Sriram et al, 2011; Ali et al, 2012; Chan et al, 2012; Jacobs et al, 2012; Chung et al, 2014; Butt et al, 2016; Chen et al, 2016; Tourkmani et al, 2016; Korcegez et al, 2017). Pharmacist provided only educational interventions without pharmaceutical care in, n = 17 studies (Sarkadi and Rosenqvist, 2004; Hayward et al, 2005; Suppapitiporn et al, 2005; Krass et al, 2007; Al Mazroui et al, 2009; Farsaei et al, 2011; Mehuys et al, 2011; Sriram et al, 2011; Chan et al, 2012; Samtia et al, 2013; Castejón et al, 2014; Chow et al, 2015; Jahangard-Rafsanjani et al, 2015; Butt et al, 2016; Lim et al, 2016; Tourkmani et al, 2016; Shao et al, 2017) or as a member of health care team in, n = 4 studies (Ko et al, 2007; Kang et al, 2010; Taveira et al, 2010; Siaw et al, …”

“…Pharmacist provided only educational interventions without pharmaceutical care in, n = 17 studies (Sarkadi and Rosenqvist, 2004; Hayward et al, 2005; Suppapitiporn et al, 2005; Krass et al, 2007; Al Mazroui et al, 2009; Farsaei et al, 2011; Mehuys et al, 2011; Sriram et al, 2011; Chan et al, 2012; Samtia et al, 2013; Castejón et al, 2014; Chow et al, 2015; Jahangard-Rafsanjani et al, 2015; Butt et al, 2016; Lim et al, 2016; Tourkmani et al, 2016; Shao et al, 2017) or as a member of health care team in, n = 4 studies (Ko et al, 2007; Kang et al, 2010; Taveira et al, 2010; Siaw et al, 2017). In rest of the included studies ( n = 22) pharmacist provided diabetes education in combination with pharmaceutical care (Armour et al, 2004; Clifford et al, 2005; Odegard et al, 2005; Rothman et al, 2005; Taylor et al, 2005; Fornos et al, 2006; Scott et al, 2006; Doucette et al, 2009; Jameson and Baty, 2010; Cohen et al, 2011; Ali et al, 2012; Jacobs et al, 2012; Jarab et al, 2012; Mahwi and Obied, 2013; Mourão et al, 2013; Chung et al, 2014; Ahmad et al, 2015; Cani et al, 2015; Wishah et al, 2015; Chen et al, 2016; Nascimentoa et al, 2016; Korcegez et al, 2017) (detail for contents of pharmaceutical care intervention for individual study, is presented in Supplementary Table 2), in a varied healthcare settings, such as primacy care clinics, community pharmacies and hospital settings.…”

“…After final assessment n = 20 studies which reported for BMI (Clifford et al, 2005; Fornos et al, 2006; Scott et al, 2006; Krass et al, 2007; Al Mazroui et al, 2009; Kang et al, 2010; Taveira et al, 2010; Ali et al, 2012; Chan et al, 2012; Jarab et al, 2012; Mourão et al, 2013; Samtia et al, 2013; Castejón et al, 2014; Jahangard-Rafsanjani et al, 2015; Wishah et al, 2015; Butt et al, 2016; Lim et al, 2016; Tourkmani et al, 2016; Korcegez et al, 2017; Shao et al, 2017) n = 16 for FBS (Clifford et al, 2005; Suppapitiporn et al, 2005; Fornos et al, 2006; Al Mazroui et al, 2009; Farsaei et al, 2011; Sriram et al, 2011; Jarab et al, 2012; Mahwi and Obied, 2013; Mourão et al, 2013; Samtia et al, 2013; Chung et al, 2014; Wishah et al, 2015; Butt et al, 2016; Lim et al, 2016; Korcegez et al, 2017; Shao et al, 2017) n = 19 studies for SBP (Clifford et al, 2005; Fornos et al, 2006; Scott et al, 2006; Al Mazroui et al, 2009; Doucette et al, 2009; Taveira et al, 2010; Cohen et al, 2011; Ali et al, 2012; Chan et al, 2012; Jacobs et al, 2012; Mourão et al, 2013; Castejón et al, 2014; Ahmad et al, 2015; Jahangard-Rafsanjani et al, 2015; Lim et al, 2016; Tourkmani et al, 2016; Korcegez et al, 2017; Shao et al, 2017; Siaw et al, 2017) n = 17 studies for DBP (Clifford et al, 2005; Fornos et al, 2006; Scott et al, 2006; Al Mazroui et al, 2009; Doucette et al, 2009; Correr et al, 2011; Ali et al, 2012; Chan et al, 2012; Jacobs et al, 2012; Jarab et al, 2012; Mourão et al, 2013; Castejón et al, 2014; Ahmad et al, 2015; Jahangard-Rafsanjani et al, 201...…”