The Impact of Pharmacist-LED Medication Therapy Management on Medication Adherence in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study

Background It is estimated that 1.6 million deaths worldwide were directly caused by diabetes in 2016, and the burden of diabetes has been increasing rapidly in low‐ and middle‐income countries. This study reviews existing interventions based on patient empowerment and their effectiveness in controlling diabetes in sub‐Saharan Africa. Method PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO and Global Health were searched through August 2018, for randomized controlled trials of educational interventions on adherence to the medication plan and lifestyle changes among adults aged 18 years and over with type 2 diabetes. Random‐effects meta‐analysis was used. Results Eleven publications from nine studies involving 2743 participants met the inclusion criteria. The duration of interventions with group education and individual education ranged from 3 to 12 months. For six studies comprising 1549 participants with meta‐analysable data on glycaemic control (HbA1c), there were statistically significant differences between intervention and control groups: mean difference was −0.57 [95% confidence interval (CI) −0.75, −0.40] (P < .00001, I2 = 27%). Seven studies with meta‐analysable data on blood pressure showed statistically significant differences between groups in favour of interventions. Subgroup analyses on glycaemic control showed that long‐term interventions were more effective than short‐term interventions and lifestyle interventions were more effective than diabetes self‐management education. Conclusion This review supports the findings that interventions based on patient empowerment may improve glycaemia (HbA1c) and blood pressure in patients with diabetes. The long‐term and lifestyle interventions appear to be the most effective interventions for glycaemic control.

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“…One study reported hospital admissions with significant reductions in the intervention group compared to the control group 40 …”

Section: Resultsmentioning

confidence: 99%

Effectiveness of interventions based on patient empowerment in the control of type 2 diabetes in sub‐Saharan Africa: A review of randomized controlled trials

Mogueo

Oga‐Omenka

Hatem

et al. 2020

Endocrino Diabet & Metabol

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“…Studies focusing on medical units have historically tended to focus on specific medical fields or ambulatory patients 51 – 57 . Also, many studies on medical wards are research projects that may not reflect real-life practice as there may have some of the following limitations: prospective studies with restrictive inclusion criteria, specific protocols and teaching programmes, small sample sizes, use of automatized DRP alerts without direct pharmacist intervention, poor methodology description of the pharmaceutical care process, lack of validated registration tools and reliable information in retrospective analyses, lack of DRP risk factors analysis or study of a limited list of potential factors, short study duration or pathology/drug-centered rather than patient-oriented approach 26 , 27 , 38 , 40 , 44 , 45 , 47 – 49 , 58 , 59 . Also, only a few studies have explored the degree of acceptance of recommendations by the medical team 35 – 37 , 39 , 40 .…”

Section: Introductionmentioning

confidence: 99%

Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions

Garin

Solé

Lucas

et al. 2021

Sci Rep

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Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions. The aim of our study was to examine the prevalence and characteristics of DRP in regular clinical pharmacy, as well as to determine those factors associated with a higher risk of DRP in the hospital setting. We analyzed data from a standardized registry database of regular pharmacy practice (2015- 2016). DRP were classified according to the Pharmaceutical Care Network Europe v6.2 classification. Cross-sectional data were obtained from 1602 adults admitted to medical wards. Crude and adjusted binary logistic regressions were performed to identify associations between potential risk factors and DRP. Overall DRP prevalence was high across medical specialties (45,1%), in a population characterized by advanced age, polypharmacy and multimorbidity. Problems leading to DRP were mainly classified into two domains (effectiveness and adverse reactions), being drug and dose selection the most frequent causes. Interventions were accepted and DRP were totally or partially solved in 74.1% and 4.81% of cases, respectively. In the adjusted model polypharmacy, allergies, BMI > 25 kg/m2 and clearance < 30 mL/min were associated with a higher risk of DRP. The participation of clinical pharmacists into multidisciplinary teams promotes the detection and solution of DRP. Polypharmacy, obesity, renal impairment and allergy are associated with a higher risk of DRP during admission.

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“…Healthcare staff can play an important role improving the self‐confidence and self‐care of patients building on patients being told how to take their medicines (Table ). This includes pharmacists and others improving patients’ knowledge about their disease, as well as ensuring they have a satisfactory experience when visiting ambulatory care clinics, to improve future medicine use . Such activities though must take account of the fact that the patient population attending CHCs in South Africa (Table ) typically have no formal education or only primary education, similar to other ambulatory care settings in South Africa and other African countries .…”

Section: Discussionmentioning

confidence: 99%

Knowledge regarding medicines management of type 2 diabetes amongst patients attending a Community Health Centre in South Africa

Moosa

Bezuidenhout

Meyer

et al. 2019

Journal of Pharmaceutical Health Services Research

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Objective The prevalence of type 2 diabetes mellitus (T2DM) is growing in Sub‐Saharan countries including South Africa. This is a concern given its appreciable impact on morbidity, mortality and costs with the recent introduction of universal health care in South Africa. The purpose of the study was to assess the knowledge of patients with T2DM attending a typical community health centre (CHC) regarding the management of their disease including risk factors and prevention to guide future initiatives. Typically, patients with T2DM in South Africa are managed in ambulatory care including CHCs. Method A quantitative, descriptive study in a CHC. The sample included 217 adults with T2DM who have visited a physician as well as the pharmacy. Face‐to‐face patient exit interviews were conducted using a structured questionnaire. Key findings Females predominated (65%), with the majority of patients >60 years (38.2%) and more than half from the Indian racial category. Most patients did not know how their medication controls their diabetes (79.3%) or did not know any of the side effects (83.9%) from their medication. Less than half of the patients knew how to take their medication, and more than a third of patients indicated that they were not practicing any form of self‐care. Conclusion The results indicate that these T2DM patients lacked sufficient knowledge regarding the management of their disease. Healthcare managers should consider instigating programmes to improve patients’ knowledge about the management of their disease as part of general initiatives within South Africa to improve the management of patients with chronic diseases in the public sector.

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The Impact of Pharmacist-LED Medication Therapy Management on Medication Adherence in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study

Cited by 13 publications

References 20 publications

Effectiveness of interventions based on patient empowerment in the control of type 2 diabetes in sub‐Saharan Africa: A review of randomized controlled trials

Effectiveness of interventions based on patient empowerment in the control of type 2 diabetes in sub‐Saharan Africa: A review of randomized controlled trials

Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions

Knowledge regarding medicines management of type 2 diabetes amongst patients attending a Community Health Centre in South Africa

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