Background
Of the 464 million patients diagnosed with diabetes mellitus globally, type 2 diabetes accounts for 90%. Type 2 diabetes contributes to other conditions such as hypertension, dyslipidaemia and cardiovascular diseases. Glycaemic haemoglobin control is essential in reducing long-term macrovascular and microvascular complications. Pharmacist interventions have been documented to have a positive role in diabetes management. In Kuwait, type 2 diabetes prevalence is increasing and found in a young population.
Aims
To evaluate the influence of the pharmacist-led intervention on diabetes knowledge, medication adherence and HbA1c, and hypertension. In addition, to estimate the 10-years risk of developing cardiovascular events and assess the cost of diabetes-related complications.
Method
The study was a randomised controlled trial with control and intervention arms conducted at the military hospital in Kuwait. Participants (n=177) were randomly allocated to the intervention group (n=88) and control group (n=89), using a 4-block randomisation procedure. The intervention group received face-to-face education and counselling from the pharmacist with a monthly follow-up for six months. The primary outcome was glycaemic control, and secondary measures were hypertension, lipid profiles, medication adherence, diabetes knowledge, 10-year estimated cardiovascular events and cost. QRISK3 and UKPDS-OM2 were used to estimate the risk of CVD events and cost comparison analysis.
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Results
Compared with baseline, the mean reduction of HbA1c, blood pressure, and lipid profiles showed significant improvement in the intervention group. Additionally, improvement in medication adherence, diabetes knowledge, 10-years estimated cardiovascular events were reported with the intervention group. Also, the pharmacist-led intervention was cost-saving.
Conclusion
The study highlighted that adult type 2 diabetes patients who received the pharmacist-led intervention experienced a reduction in adverse clinical outcomes, improved non-clinical outcomes, and assisted in lifestyle modification.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/19732 |
| Date | January 2021 |
| Creators | Alabkal, Rahma M. |
| Contributors | Silcock, Jonathan, Graham, Anne M |
| Publisher | University of Bradford, School of Pharmacy and Medical Sciences. Faculty of Life Sciences |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Thesis, doctoral, PhD |
| Rights | <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>. |
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