Supervised pharmacy student-led medication review in primary care for patients with type 2 diabetes: a randomised controlled pilot study

Abstract

ObjectiveTo pilot and feasibility-test supervised final year undergraduate pharmacy student-led medication reviews for patients with diabetes to enable definitive trial design.MethodThird year pharmacy students were recruited from one UK School of Pharmacy and trained to review patient's medical records and provide face-to-face consultations under supervision while situated within the patient's medical practice. Patients with type 2 diabetes were recruited by postal invitation letter from their medical practice and randomised via automated system to intervention or usual care. Diabetes-related clinical data, quality of life, patient reported beliefs, adherence and satisfaction with medicines information were collected with validated tools at baseline and 6 months postintervention. The process for collecting resource utilisation data was tested. Stakeholder meetings were held before and after intervention to develop study design and learn from its implementation. Recruitment and attrition rates were determined plus the quality of the outcome data. Power calculations for a definitive trial were performed on the different outcome measures to identify the most appropriate primary outcome measure.Results792 patients were identified as eligible from five medical practices. 133 (16.8%) were recruited and randomised to control (n=66) or usual care (n=67). 32 students provided the complete intervention to 58 patients. Initial data analysis showed potential for impact in the right direction for some outcomes measured including glycated haemoglobin, quality of life and patient satisfaction with information about medicines. The intervention was found to be feasible and acceptable to patients. The pilot and feasibility study enabled the design of a future full randomised controlled trial.ConclusionsStudent and patient recruitment are possible. The intervention was well received and demonstrated some potential benefits. While the intervention was relatively inexpensive and provided an experiential learning opportunity for pharmacy students, its cost-effectiveness remains to be determined.Trial registration numberISRCTN26445805; Results.

Modelling elderly patients’ perception of the community pharmacist image when providing professional services

“…(Katch & Mead, 2010) It may also be useful for University education to include training in this topic. (Adams et al, 2015;Chen, Plake, Yehle, & Kiersma, 2011;Westberg, Bumgardner, Brown, & Frueh, 2010) The results of this study also suggested that, when professional services are provided, they modify patients' 'Self-efficacy' that in turn improves 'PPI' vs. usual care. Therefore, those services focused on patient education would be the most influential on 'PPI' .…”

Effect of student-led health interventions on patient outcomes for those with cardiovascular disease or cardiovascular disease risk factors: a systematic review

“…When pairs of pharmacy students provided level two and three medication reviews to 67 patients with diabetes the intervention group had a lower post-intervention HbA1c (56.32 ± 11.5%) than the control group (59.68 ± 13.2%, n = 66, p = 0.14) who received usual care [31]. Each student pair attended to four patients [31]. Within intervention group change was − 0.49% compared to − 0.03% in the control group [31].…”

“…Student-led health interventions were primarily located in a clinic setting [31][32][33][34][35][36][37][38][39][40][41][42][43][44]. Of the student-led clinics, five studies described the service provided as a "free clinic" [33,36,41,42,44].…”

“…The exceptions to the clinic-based student-led services included one study that provided student-led home visits [45] and one study that provided a student-led discharge consultation [30]. All student-led health interventions described were located in the USA, except Adam et al [31] which was located in the United Kingdom.…”

“…Three studies found non-statistically significant changes in HbA1c when the student-led intervention was provided [31,35,39,45]. When pairs of pharmacy students provided level two and three medication reviews to 67 patients with diabetes the intervention group had a lower post-intervention HbA1c (56.32 ± 11.5%) than the control group (59.68 ± 13.2%, n = 66, p = 0.14) who received usual care [31]. Each student pair attended to four patients [31].…”