Pharmacist’s interventions to improve clinical outcomes in patients with type 2 diabetes mellitus: Nyala City, South Darfur State, Sudan
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Prospective randomized controlled interventional (pre and post) clinical trial aimed to examine impact of pharmacist’s interventions (during 1 year follow-up) on diabetes clinical outcomes of patients with type 2 diabetes in Nyala City, Sudan. Three hundred patients (200 intervention and 100 control groups) with type 2 diabetes were clinically evaluated for diabetes care contents before and after implementation of diabetes care international guidelines from Institute for Clinical Systems Improvement (ICSI). We measured patient’s general and diabetes satisfaction level regarding diabetes care, by using Patient Satisfaction (PSQ-18) and Diabetes Satisfaction (DSQ) Questionnaires. Diabetes care elements were compared against international guidelines to achieve target goals of blood glucose and HBA1c. The clinical pharmacist in collaboration with the diabetes care team implemented ICSI standards for care of patients with type 2 diabetes. The role of pharmacist in diabetes management team has involved behavioral and educational aspects of patients with type 2 diabetes, self-monitoring of blood glucose, lifestyle changes, and the status of diabetes care and general health. Clinically significant differences were achieved in terms of post-prandial blood glucose (PPBG) levels (7.4 ± 1.7 vs. 10.4 ± 2.0 mmol/L) between intervention and control groups, respectively. Percentage of intervention group that reached target PPBG increased from (12.0 to 54.0 %; p = 0.001). Percentage of intervention group that reached target HBA1c increased from 10.5 to 52.0 %. HBA1c values for intervention group were improved as compared to control group (7.8 ± 1.9 % vs. 9.5 ± 2 %; p = 0.001), respectively. Pharmacist’s interventions yielded increased percentage of intervention group as compared to control group, who achieved comprehensive diabetes clinical outcomes.
KeywordsClinical diabetes outcomes Diabetes care Diabetes satisfaction Pharmacist interventions
The authors wish to thank all participating patients, physicians, pharmacists, and nursing staff of primary health-care facilities in Nyala, South Darfur State, Sudan, for their support. We applauded the contribution: Dr. Mohammed Mandour (late former General Director of Central Medical Supplies [CMS], Khartoum, Sudan), Professor Abu Bakr Gurashi, and Professor El Hadi Mohammad (Dean Faculty of Pharmacy, University of Gezira).
Conflict of interest
Authors declare no conflict of interest.
- 1.International Diabetes Federation, Diabetes Atlas - 5th Edition, Brussels, 2011. www.idf.org. Accessed January 2012.Google Scholar
- 2.Ahmed AM, Ahmed NH. Hospitalization patterns of diabetic patients in Sudan. Diabetes Int. 2000;10:18–9.Google Scholar
- 8.Bolen SD, Chandar A, Falck-Ytter C, Tyler C, Perzynski AT, Gertz AM, et al. See comment in Pub Med commons below effectiveness and safety of patient activation interventions for adults with type 2 diabetes: systematic review, meta-analysis, and meta-regression. J Gen Intern Med. 2014;29(8):1166–76.PubMedCentralCrossRefPubMedGoogle Scholar
- 11.Gore SM a Altman DG, Statistics in Practice. British Medical Association, London. Ingelfinger JA, Mosteller F, Thibodeau LA and Ware JH (1994). Biostatistics in Clinical Medicine (3rd ed). (1982). McGraw Hill, New York.Google Scholar
- 12.Marshall GN and Hays RD. The Patient Satisfaction Questionnaire Short-Form (PSQ-18), P-7865. The RAND Corporation (RAND, Santa Monica, CA). (1994). Reprinted with permission.Google Scholar
- 13.Ware JE, Snyder MK, Wright WR. Development and Validation of Scales to Measure Patient Satisfaction with Medical Care Services. Vol I, Part A: Review of Literature, Overview of Methods and Results Regarding Construction of Scales. (NTIS Publication No. PB 288-329). Springfield, VA. Natl Tech Inf Serv. 1976a.Google Scholar
- 14.Ware JE, Snyder MK, Wright WR. Development and Validation of Scales to Measure Patient Satisfaction with Medical Care Services. Vol I, Part B: Results Regarding Scales Constructed from Patient Satisfaction Questionnaire and Measures of Other Health Care Perceptions. (NTIS Publication No. PB 288-329). Springfield, VA. Natl Tech Inf Serv. 1976a.Google Scholar
- 15.Michael S, Krishna D, Christine S. The chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis. 2013;10:1–21.Google Scholar
- 17.Oster RT, Virani S, Strong D, Shade S, Toth EL. Diabetes care and health status of first nations individuals with type 2 diabetes in Alberta. Can Fam Physician. 2009;Vol 55.Google Scholar
- 25.Og O‟Donovan D, Byrne S, Sahm L. The role of pharmacists in control and management of type 2 Diabetes Mellitus; a review of the literature. J Diabetol. 2011;1:5.Google Scholar
- 26.Moemen MM. Patient satisfaction among attendance of outpatient clinics of different clinical departments at alexandria main university hospital. Bullitin Alexandria Univ Fac Med. 2008; 44 No 1.Google Scholar
- 27.Sweileh WM, Aker O, Hamooz S. Rate of compliance among patients with diabetes mellitus and hypertension. An-Najah Univ J Res. (Najah Sciences). 2005; Vol. 19.Google Scholar
- 28.Testa M. Improving diabetes therapy: improving satisfaction. Diabetes Voice. 2003;48(4):23–5.Google Scholar
- 31.Tikinson MJ, Kumar R, Cappelleri JC, Hass SL. Hierarchical construct validity of the treatment satisfaction questionnaire for medication (TSQM Version II) among outpatient pharmacy consumers. Value Health. 2005;8 Suppl 1:S9–S24.Google Scholar
- 32.Brod M, Valensi P, Shaban JA, Bushnell DM, Christensen TL. b) Patient treatment satisfaction after switching to NovoMix® 30 (BIAsp 30) in the IMPROVE™ study: an analysis of the influence of prior and current treatment factors. Qual Life Res. 2010;19(9):1285–93.PubMedCentralCrossRefPubMedGoogle Scholar