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Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Pharmacist intervention for glycaemic control in the community (the RxING study)
Yazid N Al Hamarneh1, Theresa Charrois, Richard Lewanczuk
1Division of Cardiology, Department of Medicine, EPICORE Centre, University of Alberta, Edmonton, Alberta, Canada.
BMJ Open
|September 27, 2013
Summary
Community pharmacists improved glycemic control in type 2 diabetes patients through an insulin glargine prescribing intervention. This study demonstrates pharmacist-led care is effective for managing diabetes.
Area of Science:
- Pharmacology and Pharmaceutical Sciences
- Endocrinology and Metabolism
- Public Health and Epidemiology
Background:
- Type 2 diabetes management requires ongoing monitoring and treatment adjustments.
- Community pharmacists can play a crucial role in patient care and medication management.
- Previous studies have explored physician-led interventions for glycemic control.
Purpose of the Study:
- To evaluate the impact of a community pharmacist prescribing intervention on glycemic control.
- To assess the effectiveness of pharmacist-led insulin glargine prescribing in type 2 diabetes patients.
- To determine if pharmacist prescribing improves HbA1c levels in poorly controlled type 2 diabetes.
Main Methods:
- A pragmatic, before-after study design was employed across 12 community pharmacies in Alberta, Canada.
- Eligible participants with type 2 diabetes (HbA1c 7.5-11%) received pharmacist-prescribed insulin glargine, with dosage adjustments based on fasting glucose.
- Glycemic control was monitored via HbA1c measurements at baseline and up to 26 weeks.
Main Results:
- A significant reduction in HbA1c from 9.1% to 7.3% (a 1.8% decrease, p<0.001) was observed at 26 weeks.
- Fasting plasma glucose also decreased significantly from 11 mmol/L to 6.9 mmol/L (a 4.1 mmol/L decrease, p=0.007).
- Fifty-one percent of patients achieved the target HbA1c of ≤7% by the study's end.
Conclusions:
- Pharmacist-initiated insulin glargine prescribing significantly improved glycemic control in patients with type 2 diabetes.
- The results are comparable to physician-led interventions, highlighting the value of pharmacist-led diabetes care.
- This study provides evidence supporting the expansion of pharmacist prescribing roles in chronic disease management.
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