title: A non-clinical randomised controlled trial to assess the impact of pharmaceutical care intervention on satisfaction level of newly diagnosed diabetes mellitus patients in a tertiary care teaching hospital in Nepal.
abstract: BACKGROUND
  Patient satisfaction is the ultimate goal of healthcare system which can be achieved from good patient-healthcare professional relationship and quality of healthcare services provided. Study was conducted to determine the baseline satisfaction level of newly diagnosed diabetics and to explore the impact of pharmaceutical care intervention on patients' satisfaction during their follow-ups in a tertiary care teaching hospital in Nepal.
  
  
  METHODS
  An interventional, pre-post non-clinical randomised controlled study was designed among randomly distributed 162 [control group (n = 54), test 1 group (n = 54) and test 2 group (n = 54)] newly diagnosed diabetes mellitus patients by consecutive sampling method for 18 months. Diabetes Patient Satisfaction Questionnaire was used to evaluate patient's satisfaction scores at baseline, three, six, nine and, twelve months' follow-ups. Test groups patients were provided pharmaceutical care whereas control group patients only received their usual care from physician/nurses. The responses were entered in SPSS version 16. Data distribution was not normal on Kolmogorov-Smirnov test. Non-parametric tests i.e. Friedman test, Mann-Whitney U test and Wilcoxon signed rank test were used to find the differences among the groups before and after the intervention (p ≤0.05).
  
  
  RESULTS
  There were significant (p < 0.001) improvements in patients' satisfaction scores in the test groups on Friedman test. Mann-Whitney U test identified the significant differences in satisfaction scores between test 1 and test 2 groups, control and test 1 groups and, control and test 2 groups at 3-months (p = 0.008), (p < 0.001) and (p < 0.001), 6-months (p = 0.010), (p < 0.001) and (p < 0.001), 9-months (p < 0.001), (p < 0.001) and (p < 0.001) and, 12-months (p < 0.001), (p < 0.001) and (p < 0.001) follow-ups respectively.
  
  
  CONCLUSIONS
  Pharmaceutical care intervention significantly improved the satisfaction level of diabetics in the test groups compare to the control group. Diabetic kit demonstration strengthened the satisfaction level among the test 2 group patients. Therefore, pharmacist can act as a counsellor through pharmaceutical care program and assist the patients in managing their disease. This will not only modify the patients' related outcomes and their level of satisfaction but also improve the healthcare system.
authors.affiliation: Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. din.sun2030@gmail.com.|Department of Pharmacology, Manipal College of Medical Sciences and Manipal Teaching Hospital, Pokhara, Nepal. din.sun2030@gmail.com.
authors.forename: Dinesh Kumar
authors.initials: DK
authors.lastname: Upadhyay
authors.affiliation: College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar. mohamedizham@qu.edu.qa.
authors.forename: Mohamed Izham
authors.initials: MI
authors.lastname: Mohamed Ibrahim
authors.affiliation: American University of the Caribbean School of Medicine, 1 University Drive at Jordan Road, Cupecoy, St. Maarten. pmishra@aucmed.edu.
authors.forename: Pranaya
authors.initials: P
authors.lastname: Mishra
authors.affiliation: Department of Medicine, Manipal College of Medical Sciences and Manipal Teaching Hospital, Pokhara, Nepal. vijayalurkar@yahoo.co.in.
authors.forename: Vijay M
authors.initials: VM
authors.lastname: Alurkar
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D019538:Health Care Surveys; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal; D017060:Patient Satisfaction; D010549:Personal Satisfaction; D010593:Pharmaceutical Services; D010595:Pharmacists; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care