Effect of a Pharmacist-Led Program on Improving Outcomes in Patients with Type 2 Diabetes Mellitus from Northern Cyprus: A Randomized Controlled Trial

Korcegez, Eylem Ilktac; Sancar, Mesut; Demirkan, Kutay

doi:10.18553/jmcp.2017.23.5.573

Cited by 48 publications

(124 citation statements)

References 38 publications

(54 reference statements)

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“…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, …”

Section: Resultsmentioning

confidence: 99%

“…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). …”

Section: Resultsmentioning

confidence: 99%

“…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, …”

Section: Resultsmentioning

confidence: 99%

“…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. The control group in the included studies received usual care.…”

Section: Resultsmentioning

confidence: 99%

“…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...…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2018

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Background: Comparative efficacy of different pharmacist based interventions on glycemic control of type 2 diabetes patients is unclear. This review aimed to evaluate and compare the efficacy of different pharmacist based interventions on clinical outcomes of type 2 diabetes patients.Methods: A systematic search was conducted across five databases from date of database inception to September 2017. All randomized clinical trials evaluating the efficacy of pharmacist based interventions on type 2 diabetes patients were included for network meta-analysis (NMA). The protocol is available with PROSPERO (CRD42017078854).Results: A total of 43 studies, involving 6259 type 2 diabetes patients, were included. NMA demonstrated that all interventions significantly lowered glycosylated hemoglobin (HbA1c) levels compared to usual care, but there was no statistical evidence from this study that one intervention was significantly better than the other for reducing HbA1c levels. Pharmacist based diabetes education plus pharmaceutical care showed maximum efficacy for reducing HbA1c levels [−0.86, 95% CI −0.983, −0.727; p < 0.001]. Pharmacist based diabetes education plus pharmaceutical care was observed to be statistically significant in lowering levels of systolic blood pressure [−4.94; 95%CI −8.65, −1.23] and triglycerides levels [−0.26, 95%CI −0.51, −0.01], as compared to the interventions which involved diabetes education by pharmacist, and for body mass index (BMI) [−0.57; 95%CI −1.25, −0.12] in comparison to diabetes education by health care team involving pharmacist as member.Conclusion: The findings of this review demonstrate that all interventions had a significantly positive effect on HbA1c, but there was no statistical evidence from this study that one intervention was significantly better than the other for achieving glycemic control.Pharmacist based diabetes education plus pharmaceutical care showed maximum efficacy on HbA1c and rest of the clinical outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2018

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Effect of a Remotely Delivered Tailored Multicomponent Approach to Enhance Medication Taking for Patients With Hyperlipidemia, Hypertension, and Diabetes

Isaac²,

et al. 2018

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IMPORTANCE Approximately half of patients with chronic conditions are nonadherent to prescribed medications, and interventions have been only modestly effective. OBJECTIVE To evaluate the effect of a remotely delivered multicomponent behaviorally tailored intervention on adherence to medications for hyperlipidemia, hypertension, and diabetes. DESIGN, SETTING, AND PARTICIPANTS Two-arm pragmatic cluster randomized controlled trial at a multispecialty group practice including participants 18 to 85 years old with suboptimal hyperlipidemia, hypertension, or diabetes disease control, and who were nonadherent to prescribed medications for these conditions. INTERVENTIONS Usual care or a multicomponent intervention using telephone-delivered behavioral interviewing by trained clinical pharmacists, text messaging, pillboxes, and mailed progress reports. The intervention was tailored to individual barriers and level of activation. MAIN OUTCOMES AND MEASURES The primary outcome was medication adherence from pharmacy claims data. Secondary outcomes were disease control based on achieved levels of low-density lipoprotein cholesterol, systolic blood pressure, and hemoglobin A 1c from electronic health records, and health care resource use from claims data. Outcomes were evaluated using intention-to-treat principles and multiple imputation for missing values. RESULTS Fourteen practice sites with 4078 participants had a mean (SD) age of 59.8 (11.6) years; 45.1% were female. Seven sites were each randomized to intervention or usual care. The intervention resulted in a 4.7% (95% CI, 3.0%-6.4%) improvement in adherence vs usual care but no difference in the odds of achieving good disease control for at least 1 (odds ratio [OR], 1.10; 95% CI, 0.94-1.28) or all eligible conditions (OR, 1.05; 95% CI, 0.91-1.22), hospitalization (OR, 1.02; 95% CI, 0.78-1.34), or having a physician office visit (OR, 1.11; 95% CI, 0.91-1.36). However, intervention participants were significantly less likely to have an emergency department visit (OR, 0.62; 95% CI, 0.45-0.85). In as-treated analyses, the intervention was associated with a 10.4% (95% CI, 8.2%-12.5%) increase in adherence, a significant increase in patients achieving disease control for at least 1 eligible condition (OR, 1.24; 95% CI, 1.03-1.50), and nonsignificantly improved disease control for all eligible conditions (OR, 1.18; 95% CI, 0.99-1.41). CONCLUSIONS AND RELEVANCE A remotely delivered multicomponent behaviorally tailored intervention resulted in a statistically significant increase in medication adherence but did not change clinical outcomes. Future work should focus on identifying which groups derive the most clinical benefit from adherence improvement efforts. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02512276

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Pharmacist services for non-hospitalised patients

Barra

Scott

et al. 2018

Cochrane Database of Systematic Reviews

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The results demonstrate that pharmacist services have varying effects on patient outcomes compared with usual care. We found no studies comparing services delivered by pharmacists with other healthcare professionals that evaluated the impact of the intervention on the six main outcome measures. The results need to be interpreted cautiously because there was major heterogeneity in study populations, types of interventions delivered and reported outcomes.There was considerable heterogeneity within many of the meta-analyses, as well as considerable variation in the risks of bias.

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Effect of a Pharmacist-Led Program on Improving Outcomes in Patients with Type 2 Diabetes Mellitus from Northern Cyprus: A Randomized Controlled Trial

Cited by 48 publications

References 38 publications

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

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

Effect of a Remotely Delivered Tailored Multicomponent Approach to Enhance Medication Taking for Patients With Hyperlipidemia, Hypertension, and Diabetes

Pharmacist services for non-hospitalised patients

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