The pharmacy diabetes care program: assessment of a community pharmacy diabetes service model in Australia
Krass, I and Armour, CL and Mitchell, B and Brillant, M and Dienaar, R and Hughes, J and Lau, P and Peterson, GM and Stewart, K and Taylor, S and Wilkinson, J, The pharmacy diabetes care program: assessment of a community pharmacy diabetes service model in Australia, Diabetic Medicine, 24, (6) pp. 677-683. ISSN 0742-3071 (2007) [Refereed Article]
Aim 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 HbA1c 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.
Conclusion 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.
community pharmacy;health-care delivery;management;Type 2 diabetes