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Caring for poorly controlled diabetes mellitus: a randomized pharmacist intervention.
Peggy S Odegard1, Alvin Goo, Jeff Hummel
1School of Pharmacy, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195-7630, USA. podegard@u.washington.edu
The Annals of Pharmacotherapy
|February 11, 2005
Summary
Pharmacist interventions did not improve diabetes control (HbA1c) but reduced physician visits. Medication appropriateness and adherence remained unchanged in this randomized trial.
Area of Science:
- Clinical Pharmacy
- Diabetes Management
- Health Services Research
Background:
- Limited randomized controlled trials exist on pharmacist interventions for diabetes control.
- Effective strategies are needed to improve glycemic control in patients with poorly controlled diabetes.
Purpose of the Study:
- To assess the impact of a pharmacist intervention on diabetes control, specifically hemoglobin A1c (HbA1c).
- Secondary objectives included evaluating medication appropriateness and self-reported adherence.
Main Methods:
- A randomized controlled trial involving 77 adults with HbA1c ≥9% receiving either pharmacist intervention or usual care.
- Intervention included pharmacist-led diabetes care plans and adherence support over 6 months.
- Assessments of HbA1c, medication appropriateness, and adherence occurred at baseline, 6, and 12 months.
Main Results:
- No significant difference in mean HbA1c between groups over 12 months (p=0.61).
- Both groups showed HbA1c reduction from baseline (p=0.001), with usual care relying more on physician visits.
- Pharmacist intervention did not improve medication appropriateness (p=0.65) or self-reported adherence.
Conclusions:
- The pharmacist intervention did not significantly improve glycemic control (HbA1c) in poorly controlled diabetes.
- The intervention facilitated similar HbA1c control with fewer physician visits.
- Medication appropriateness and self-reported adherence were not enhanced compared to usual care.