Community Pharmacist-Led Interventions in Patients with Type 2 Diabetes in Low-and Middle-Income Countries: A Scoping Review

Abstract

Aims. To provide an overview of the types of interventions performed by community pharmacists and describe their effects on patients with type 2 diabetes mellitus (T2DM) in low- and middle-income countries (LMICs). Methods. This review was conducted according to the PRISMA-Scr guidelines. PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for (non-) randomized controlled, before-after, and interrupted time series design. There was no restriction in the publication language. Included interventions had to be delivered by community pharmacists in primary care and community settings. The study quality was assessed using the National Institute of Health tools. Results were analyzed descriptively. Results. Twenty-eight studies were included representing 4,434 patients (mean age from 47.4 to 59.5 years, 55.4% female). Four studies were single- and the remaining studies were multiple-component interventions. Face-to-face counseling of patients was the most common intervention, often combined with providing printed materials, remote consultations, or conducting medication reviews. Generally, studies showed improved outcomes in the intervention group, including clinical, patient-reported and medication safety outcomes. In most studies at least one domain was judged to be of poor quality, with heterogeneity among studies. Conclusions. Community pharmacist-led interventions among T2DM patients showed positive effects in LMICs, but the quality of the evidence was poor. Face-to-face counseling of varying intensity, often combined with other strategies, was the most common type of intervention. Although these findings support the expansion of the role of the community pharmacist in diabetes care in LMICs, better quality studies are needed to evaluate further impact.

Assessment the knowledge of community pharmacists in diabetic patients counseling in Ha’il, Saudi Arabia

“…It has a rapidly rising prevalence in both developed and developing countries with more than 422 million people thought to be suffering from the disease globally in 2014 (4). The International Pharmaceutical Federation and the World Health Organization have developed guidelines for community pharmacists' roles on how to provide optimal care for patients in need of medication and how to educate and monitor patients, as well as improve their medication management (5). Community pharmacists are considered the most accessible healthcare professionals; no appointments are required to see them and have the highest level of patient contact.…”