Impact of community pharmacy diabetes monitoring and education programme on diabetes management: a randomized controlled study.
OBJECTIVE
To evaluate the impact of a pharmacist-led patient education and diabetes monitoring programme on HbA(1c) and other cardiovascular risk factors in the community setting.


METHODS
Patients with Type 2 diabetes (n = 46) attending two community pharmacies in Hertfordshire, UK were randomized to one of two groups. Patients in the intervention group (n = 23) received a programme of education about diabetes, its treatment and associated cardiovascular risk factors. These patients were seen for monitoring/counselling by a community pharmacist on six occasions over a 12-month period. Measures included HbA(1c), BMI, blood pressure, blood glucose and lipid profile. Patients in the control group (n = 23) underwent these measurements at baseline and at 12 months only, without specific counselling or education over and above usual care.


RESULTS
HbA(1c) fell from 66 mmol/mol (8.2%) to 49 mmol/mol (6.6%) (P < 0.001) in intervention group, compared with reduction from 65 mmol/mol (8.1%) to 59 mmol/mol (7.5%) in the control group (P = 0.03). Blood pressure fell from 146/87 to 126/81 mmHg in the intervention group (P = 0.01) compared with no significant change in the control group (136/86 to 139/82 mmHg). Significant reductions in BMI (30.8 to 27 kg/m(2), P < 0.001) and blood glucose (8.8 to 6.9 mmol/l, P < 0.001) were also observed in the intervention group as compared with no significant changes in the control group. Lipid profile changes were mixed. In the intervention group, improvements were seen in diabetes-related quality of life (P = 0.001), diabetes knowledge (P = 0.018), belief about the need for medication (P = 0.004) and reduced concerns regarding medication (P < 0.001).


CONCLUSIONS
Education and counselling by community pharmacists can result in favourable improvements to the cardiovascular risk profile of patients with Type 2 diabetes.
School of Pharmacy, University of Hertfordshire, Hatfield, UK. m.8.ali@herts.ac.uk
M
M
Ali
F
F
Schifano
P
P
Robinson
G
G
Phillips
L
L
Doherty
P
P
Melnick
L
L
Laming
A
A
Sinclair
S
S
Dhillon
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D003157:Community Pharmacy Services; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology* / Q000628:therapy; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010865:Pilot Projects; D011446:Prospective Studies; D013222:State Medicine; D006113:United Kingdom
D006442:Glycated Hemoglobin; D008055:Lipids