The Pharmacy Diabetes Care Program: assessment of a community pharmacy diabetes service model in Australia.
OBJECTIVE
To assess the impact of a community pharmacy diabetes service model on patient outcomes in Type 2 diabetes.


METHODS
The study utilized a multisite, control vs. intervention, repeated-measures design within four states in Australia. Fifty-six community pharmacies, 28 intervention and 28 control, were randomly selected from a representative sample of urban and rural areas. Intervention pharmacies delivered a diabetes service to patients with Type 2 diabetes, which comprised an ongoing cycle of assessment, management and review, provided at regular intervals over 6 months in the pharmacy. These services included support for self monitoring of blood glucose, education, adherence support, and reminders of checks for diabetes complications. Control pharmacists assessed patients at 0 and 6 months and delivered no intervention.


RESULTS
A total of 289 subjects (149 intervention and 140 control) completed the study. For the intervention subjects, the mean blood glucose level decreased over the 6-month study from 9.4 to 8.5 mmol/l (P < 0.01). Furthermore, significantly greater improvements in glycaemic control were seen in the intervention group compared with the control: the mean reduction in HbA(1c) in the intervention group was -0.97% (95% CI: -0.8, -1.14) compared with -0.27% (95% CI: -0.15, -0.39) in the control group. Improvements were also seen in blood pressure control and quality of life in the intervention group.


CONCLUSIONS
A pharmacy diabetes service model resulted in significant improvements in clinical and humanistic outcomes. Thus, community pharmacists can contribute significantly to improving care and health outcomes for patients with Type 2 diabetes. Future research should focus on clarifying the most effective elements of the service model.
Krass
I
I
Faculty of Pharmacy, Sydney University, NSW, Australia. inesk@pharm.usyd.edu.au
Armour
C L
CL
Mitchell
B
B
Brillant
M
M
Dienaar
R
R
Hughes
J
J
Lau
P
P
Peterson
G
G
Stewart
K
K
Taylor
S
S
Wilkinson
J
J
D001315:Australia; D003157:Community Pharmacy Services / Q000592:standards*; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D015397:Program Evaluation; D019035:Rural Health Services / Q000592:standards; D019037:Urban Health Services / Q000592:standards