Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial

Ayadurai, Shamala; Sunderland, V Bruce; Tee, Lisa; Said, Siti N. Md; Hattingh, Laetitia

doi:10.1111/1753-0407.12799

Cited by 13 publications

(38 citation statements)

References 38 publications

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“…Of the 11 RCTs included in the meta‐analysis, 5 studies (694 patients) reported HbA1c . Meta‐analysis of data from the 5 studies showed statistical significant reduction in favour of practice pharmacist interventions, with a pooled effect of 0.76% greater reduction in HbA1c (95% CI −0.37 to −1.15, Z = 3.81; P = .0001) when compared to usual care.…”

Section: Resultsmentioning

confidence: 99%

“…Sixty‐six studies were subsequently excluded because of study design, interventions not located in general practice setting, study protocol, conference abstract, no relevant outcome, interventions provided to primary healthcare physician and/or the pharmacist involved in collaboration with other healthcare providers. Finally, 21 RCTs contributed to the systematic review . Of these, 11 studies were included in the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The included studies were either cluster randomised controlled trials or were randomised controlled trials conducted in general practice. The studies were conducted in different countries including: 10 in USA, 4 in Canada, 3 in Brazil, and 1 each in Jordan, Chile, Malaysia and Thailand Appendix S2,. presents further characteristics of the studies included in this systematic review.…”

Section: Resultsmentioning

confidence: 99%

“…presents further characteristics of the studies included in this systematic review. Of the 21 included studies, 14 were included patients with diabetes, 7 with hypertension and 2 with dyslipidaemia . Pharmacists used multifaceted interventions including patient education, medication review and counselling, physical assessment (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven RCTs included in the meta‐analysis (2253 patients) used 2 similar interventions, medication review and medication management . Only 1 trial that measured clinical endpoints was excluded, as appropriate data were not available.…”

Section: Resultsmentioning

confidence: 99%

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Impact of the pharmacist‐led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta‐analysis of randomised controlled trials

Alshehri

Jalal

Cheema

et al. 2020

Brit J Clinical Pharma

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Aims:To conduct a systematic review and meta-analysis of the effectiveness of general practice-based pharmacist interventions in reducing the medical risk factors for the primary prevention of cardiovascular events. Methods:A systemic search was undertaken in 8 databases: PubMed, MEDLINE, EMBAS, PsycINFO, Cochrane Library, CINAHL Plus, SCOPUS and Science Citation Index, with no start date up to 27 March 2019. Randomised controlled trials assessing the effectiveness of pharmacist-led interventions delivered in the general practice in reducing the medical risk factors of cardiovascular events were included in the review. The risk of bias in the studies was assessed using the Cochrane risk of bias tool. Results: A total of 1604 studies were identified, with 21 randomised controlled trials (8933 patients) meeting the inclusion criteria. Fourteen studies were conducted in patients with diabetes, 7 in hypertension, 2 involving dyslipidaemia, and 2 with hypertension and diabetes together. The most frequently used interventions were medication review and medication management. The quality of the included studies was variable. Patients receiving pharmacist-led interventions were associated with a statistically significant reduction in their systolic blood pressure (−9.33 mmHg [95% Confidence Interval (CI) −13.36 to −5.30]), haemoglobin A1C (−0.76% [95% CI −1.15 to −0.37]) and low-density lipoprotein-cholesterol (−15.19 mg/dL [95% CI −24.05 to −6.33]). Moreover, practice-based pharmacists' interventions were also reported to have a positive impact on patient adherence to medications. Conclusion:The findings of this review suggest that pharmacist-led interventions in general practice can significantly reduce the medical risk factors of cardiovascular disease events. These findings support the involvement of pharmacists as healthcare providers in managing patients with hypertension, diabetes and dyslipidaemia. K E Y W O R D Scardiovascular disease, general practice, pharmacist PI statement: The authors confirm that the Principal Investigator for this paper is Abdullah A. Alshehri and that he had direct clinical responsibility for patients.

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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

Impact of the pharmacist‐led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta‐analysis of randomised controlled trials

Alshehri

Jalal

Cheema

et al. 2020

Brit J Clinical Pharma

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Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

Yogasingam

Konnyu

Lépine

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a large body of evidence evaluating quality improvement (QI) programmes to improve care for adults living with diabetes. These programmes are often comprised of multiple QI strategies, which may be implemented in various combinations. Decision‐makers planning to implement or evaluate a new QI programme, or both, need reliable evidence on the relative effectiveness of different QI strategies (individually and in combination) for different patient populations. Objectives To update existing systematic reviews of diabetes QI programmes and apply novel meta‐analytical techniques to estimate the effectiveness of QI strategies (individually and in combination) on diabetes quality of care. Search methods We searched databases (CENTRAL, MEDLINE, Embase and CINAHL) and trials registers (ClinicalTrials.gov and WHO ICTRP) to 4 June 2019. We conducted a top‐up search to 23 September 2021; we screened these search results and 42 studies meeting our eligibility criteria are available in the awaiting classification section. Selection criteria We included randomised trials that assessed a QI programme to improve care in outpatient settings for people living with diabetes. QI programmes needed to evaluate at least one system‐ or provider‐targeted QI strategy alone or in combination with a patient‐targeted strategy. ‐ System‐targeted: case management (CM); team changes (TC); electronic patient registry (EPR); facilitated relay of clinical information (FR); continuous quality improvement (CQI). ‐ Provider‐targeted: audit and feedback (AF); clinician education (CE); clinician reminders (CR); financial incentives (FI). ‐ Patient‐targeted: patient education (PE); promotion of self‐management (PSM); patient reminders (PR). Patient‐targeted QI strategies needed to occur with a minimum of one provider or system‐targeted strategy. Data collection and analysis We dual‐screened search results and abstracted data on study design, study population and QI strategies. We assessed the impact of the programmes on 13 measures of diabetes care, including: glycaemic control (e.g. mean glycated haemoglobin (HbA1c)); cardiovascular risk factor management (e.g. mean systolic blood pressure (SBP), low‐density lipoprotein cholesterol (LDL‐C), proportion of people living with diabetes that quit smoking or receiving cardiovascular medications); and screening/prevention of microvascular complications (e.g. proportion of patients receiving retinopathy or foot screening); and harms (e.g. proportion of patients experiencing adverse hypoglycaemia or hyperglycaemia). We modelled the association of each QI strategy with outcomes using a series of hierarchical multivariable meta‐regression models in a Bayesian framework. The previous version of this review identified that different strategies were more or less effective depending on baseline levels of outco...

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Effect of pharmacist interventions on reducing low-density lipoprotein cholesterol (LDL-C) levels: A systematic review and meta-analysis

Khaddage

Bhagat

Koenig

et al. 2020

Journal of Clinical Lipidology

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Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial

Abstract: Using the Simpler tool facilitated the delivery of comprehensive evidence-based diabetes management and significantly improved clinical outcomes. The Simpler tool supported pharmacists in providing enhanced structured diabetes care.

Cited by 13 publications

References 38 publications

Impact of the pharmacist‐led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta‐analysis of randomised controlled trials

Impact of the pharmacist‐led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta‐analysis of randomised controlled trials

Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

Effect of pharmacist interventions on reducing low-density lipoprotein cholesterol (LDL-C) levels: A systematic review and meta-analysis

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