Pharmaceutical care model for patients with type 2 diabetes: integration of the community pharmacist into the diabetes team--a pilot study.
OBJECTIVE
To evaluate the feasibility and impact of a structured approach for community pharmacist input as a member of the multidisciplinary team caring for patients with type-2 diabetes and health professional providing advice on medication.


METHODS
Prospective pretest-posttest single group study. Sixty-two patients on oral hypoglycaemic therapy, identified as regular customers of four Scottish (UK) community pharmacies, were recruited. Each patient underwent an initial assessment: review of medical general practice notes/community pharmacy PMR (Patient medication record) system and structured interview. Standardised documentation was completed, a pharmaceutical care plan (PCP) prepared, peer-reviewed and then discussed face-to-face with patients' GPs (general practitioners). A second (final) assessment was conducted 24 to 28 weeks from the initial interview.


METHODS
Pharmaceutical care issues (PCIs) throughout study period; change in parameters from initial to final assessment: patient knowledge of oral hypoglycaemic and anti-hypertensive therapy; HbA1c; blood pressure; total cholesterol; medication compliance.


RESULTS
A total of 178 PCIs were identified (mean [range] 2.9 [1-5] per patient) and categorised: drug therapy problems (n = 76); monitoring (n = 21); and patient knowledge (n = 81). Drug therapy problems discussed with the GPs were agreed for 74 (97%) and resolved for 55 (72%) at final assessment. Biological outcome measures were assessed for 59 patients (3 drop-outs). A reduction (P < 0.05) in HbA1 c, blood pressure and total cholesterol was observed over the study period. Patients knowledge was poor for oral hypoglycaemic therapy but improved (initial-51 %, final-72%, P < 0.05).


CONCLUSIONS
This study demonstrated a feasible pharmaceutical care model for diabetes patients in an European country. The results have shown the pharmacist to be effective and well accepted by GPs and patients.
Wermeille
Joel
J
Pharmacy Service, Hôpital du Jura Bernois SA, Rue Beausite 49, 2740 Moutier, Switzerland. joel.wermeille@hjbe.ch
Bennie
Marion
M
Brown
Ian
I
McKnight
John
J
D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000639:trends; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D017146:Models, Organizational; D005791:Patient Care / Q000639:trends; D010348:Patient Care Team / Q000458:organization & administration* / Q000639:trends; D010595:Pharmacists / Q000458:organization & administration / Q000639:trends*; D010865:Pilot Projects; D024382:Professional Role; D016896:Treatment Outcome; D006113:United Kingdom
D007004:Hypoglycemic Agents