Evaluation of a pharmaceutical care model on diabetes management.
OBJECTIVE
To assess the effectiveness of a pharmaceutical care model on the management of non-insulin-dependent diabetes mellitus (NIDDM) in urban African-American patients.


METHODS
Eligible patients were randomized to either a pharmacist intervention or control group and followed over a 4-month period. Patients in the intervention group received diabetes education, medication counseling, instructions on dietary regulation, exercise, and home blood glucose monitoring, and evaluation and adjustment of their hypoglycemic regimen. Patients in the control group continued to receive standard medical care provided by their physicians.


METHODS
A university-affiliated internal medicine outpatient clinic.


METHODS
The study population consisted of urban African American patients with NIDDM currently attending the clinic.


METHODS
Primary outcome measures included fasting plasma glucose and glycated hemoglobin concentrations. Secondary outcome endpoints included blood pressure, serum creatinine, creatinine clearance, microalbumin to creatinine ratio, total cholesterol, triglycerides, high-density lipoprotein, and low density lipoprotein concentrations. Quality-of-life assessments were performed in both groups at baseline and at the end of the study.


RESULTS
Thirty-nine patients (17 intervention, 22 control) completed the study. The intervention group consisted of 12 women and 5 men with a mean +/- SD age of 59 +/- 12 years, total body weight (TBW) of 93 +/- 22 kg, body mass index (BMI) of 34 +/- 7 kg/m2, and duration of NIDDM 6.8 +/- 6.5 years. The control group consisted of 15 women and 7 men with a mean age of 65 +/- 12 years, TBW of 88 +/- 19 kg, BMI of 33 + 7 kg/m2, and a duration of NIDDM of 6.2 +/- 4.8 y. Significant improvement in glycated hemoglobin (p = 0.003) and fasting plasma glucose (p =0.015) was achieved in the intervention group. No change in glycemia was observed in the control subjects. Statistically significant differences in the final glycated hemoglobin (p = 0.003) and fasting plasma glucose (p = 0.022) concentrations were noted between groups. No significant changes in blood pressure control, lipid profile, renal function parameters, weight, or quality-of-life measures were noted within or between groups.


CONCLUSIONS
Our data demonstrate the effectiveness of pharmaceutical care in the reduction of hyperglycemia associated with NIDDM in a group of urban African-American patients.
Jaber
L A
LA
Department of Pharmacy Practice, Wayne State University, Detroit, MI 48201, USA.
Halapy
H
H
Fernet
M
M
Tummalapalli
S
S
Diwakaran
H
H
D000368:Aged; D044383:Black People; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic; D010607:Pharmacy Service, Hospital; D011788:Quality of Life; D014505:Urban Population; D001741:Black or African American
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents