Skip to main content
SpringerLink
Log in

Impact of pharmacist-involved collaborative care on diabetes management in a primary healthcare setting using real-world data

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Diabetes mellitus is a complex multi-system disorder, requiring multi-disciplinary care. The conventional care model, where physicians are the sole caregivers may not be optimal. Addition of other healthcare team members improves healthcare outcomes for patients with diabetes. Aim To evaluate the impact of pharmacist-involved collaborative care on diabetes-related outcomes among patients with diabetes attending a primary healthcare setting  in Qatar using real-world data. Method A retrospective cohort study was conducted among patients with diabetes attending Qatar Petroleum Diabetes Clinic. Patients were categorized as either receiving pharmacist-involved collaborative care (intervention group) or usual care (control group). Data were analyzed using SPSS®. Glycemic control (glycated hemoglobin A1c, HbA1c), blood pressure, lipid profile, and body mass index were evaluated at baseline and up to 17 months of follow-up. Results After 17 months of follow-up, pharmacist-involved collaborative care compared to usual care resulted in a significant decrease in HbA1c (6.8 ± 1.2% vs. 7.1 ± 1.3%, p < 0.01). Moreover, compared to baseline, pharmacist-involved collaborative care significantly improved (p < 0.05) the levels of HbA1c (7.5% vs. 6.8%), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), and body mass index (30.42 kg/m2 vs. 30.17 kg/m2) after 17 months within the intervention group. However, no significant changes for these parameters occurred within the control group. Conclusion The implementation of pharmacist-involved collaborative care in a primary healthcare setting improved several diabetes-related outcomes over 17 months. Future studies should determine the long-term impact of this care model.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of data and material

Data support published claims.

References

  1. Schmidt AM. Highlighting diabetes mellitus: the epidemic continues. Arterioscler Thromb Vasc Biol. 2018;38(1):e1–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Rhys W, Colagiuri S, Almutairi R, et al. IDF Diabetes Atlas ninth edition. International Diabetes Federation; 2019. ISBN: 978-2-930229-87-4

  3. Internaltional Diabetes Federation. IDF diabetes atlas [Internet]. 2013 [cited 2019 Oct 12]. p. 12. www.idf.org/diabetesatlas

  4. Saudek CD. The role of primary care professionals in managing diabetes. Clin Diabetes. 2002;20:65–6.

    Google Scholar 

  5. World Health Organization. The top 10 causes of death [Internet]. 2018 [cited 2019 Dec 5]. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

  6. DeLoach C. The Impact of Interprofessional Collaboration on Diabetes Outcomes in Primary Care Settings. Dissertation. Walden University; 2018.

  7. Baptista DR, Wiens A, Pontarolo R, et al. The chronic care model for type 2 diabetes: a systematic review. Diabetol Metab Syndr. 2016;8:1–7.

    Google Scholar 

  8. Daiski I. An expanded model of diabetes care based in an analysis and critique of current approaches. J Clin Nurs. 2008;17:310–7.

    PubMed  Google Scholar 

  9. Noor Abdulhadi NM, Al-Shafaee MA, Wahlström R, et al. Doctors’ and nurses’ views on patient care for type 2 diabetes: an interview study in primary health care in Oman. Prim Heal Care Res Dev. 2013;14:258–69.

    Google Scholar 

  10. Schwartz DD, Stewart SD, Aikens JE, et al. Seeing the person, not the illness: Promoting diabetes medication adherence through patient-centered collaboration. Clin Diabetes. 2017;35:35–42.

    PubMed  PubMed Central  Google Scholar 

  11. Johnson JM, Carragher R. Interprofessional collaboration and the care and management of type 2 diabetic patients in the Middle East: A systematic review. J Interprof Care. 2018;32:621–8.

    CAS  PubMed  Google Scholar 

  12. Gucciardi E, Espin S, Morganti A, et al. Exploring interprofessional collaboration during the integration of diabetes teams into primary care. BMC Fam Pract. 2016;17:12.

    PubMed  PubMed Central  Google Scholar 

  13. Abdulrhim S, Sankaralingam S, Ibrahim M, et al. The impact of pharmacist care on diabetes outcomes in primary care settings: An umbrella review of published systematic reviews. Prim Care Diabetes. 2020;14:393–400.

    PubMed  Google Scholar 

  14. Wubben DP, Vivian EM. Effects of pharmacist outpatient interventions on adults with diabetes mellitus: a systematic review. Pharmacotherapy. 2008;28:421–36.

    PubMed  Google Scholar 

  15. Machado M, Bajcar J, Guzzo GC, et al. Sensitivity of patient outcomes to pharmacist interventions. Part I: systematic review and meta-analysis in diabetes management. Ann Pharmacother. 2007;41:1569–82.

    PubMed  Google Scholar 

  16. Lee JK, McCutcheon RM, Fazel MT, et al. Assessment of interprofessional collaborative practices and outcomes in adults with diabetes and hypertension in primary care: a systematic review and meta-analysis. JAMA Netw Open. 2021. https://doi.org/10.1001/jamanetworkopen.2020.36725.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nogueira M, Otuyama LJ, Rocha PA, et al. Pharmaceutical care-based interventions in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials. Einstein (Sao Paulo). 2020;18:eRW4686. https://doi.org/10.31744/einstein_journal/2020RW4686

    Article  Google Scholar 

  18. Hughes J, Wibowo Y, Sunderland B, et al. The role of the pharmacist in the management of type 2 diabetes: current insights and future directions. Integr Pharm Res Pract. 2017;6:15–27.

    PubMed  PubMed Central  Google Scholar 

  19. Simpson SH, MacCallum L, Mansell K. Pharmacy practice and diabetes care. Can J Diabetes. 2017;41:549–50.

    PubMed  Google Scholar 

  20. Yu J, Shah BM, Ip EJ, et al. A Markov model of the cost-effectiveness of pharmacist care for diabetes in prevention of cardiovascular diseases: evidence from Kaiser Permanente Northern California. J Manag Care Pharm. 2013;19:102–14.

    PubMed  Google Scholar 

  21. Nau DP, Pacholski AM. Impact of pharmacy care services on patients’ perceptions of health care quality for diabetes. J Am Pharm Assoc. 2007;47:358–65.

    Google Scholar 

  22. Fazel MT, Bagalagel A, Lee JK, et al. Impact of diabetes care by pharmacists as part of health care team in ambulatory settings: a systematic review and meta-analysis. Ann Pharmacother. 2017;51:890–907.

    PubMed  Google Scholar 

  23. Madden J, Barnard A, Owen C. Utilisation of multidisciplinary services for diabetes care in the rural setting. Aust J Rural Health. 2013;21:28–34.

    PubMed  Google Scholar 

  24. Pannick S, Davis R, Ashrafian H, et al. Effects of interdisciplinary team care interventions on general medical wards: a systematic review. JAMA Intern Med. 2015;175:1288–98.

    PubMed  Google Scholar 

  25. Najarian J, Bartman K, Kaszuba J, et al. Improving glycemic control in the acute care setting through nurse education. J Vasc Nurs. 2013;31:150–7.

    PubMed  Google Scholar 

  26. Grembowski D, Paschane D, Diehr P, et al. Managed care, physician job satisfaction, and the quality of primary care. J Gen Intern Med. 2005;20:271–7.

    PubMed  PubMed Central  Google Scholar 

  27. Conca T, Saint-Pierre C, Herskovic V, et al. Multidisciplinary collaboration in the treatment of patients with type 2 diabetes in primary care: analysis using process mining. J Med Internet Res. 2018;20:e127.

    PubMed  PubMed Central  Google Scholar 

  28. Saint-Pierre C, Herskovic V, Sepúlveda M. Multidisciplinary collaboration in primary care: a systematic review. Fam Pract. 2018;35:132–41.

    PubMed  Google Scholar 

  29. Faul F, Erdfelder E, Buchner A, et al. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149–60.

    PubMed  Google Scholar 

  30. Cranor CW, Christensen DB. The Asheville project: Short-term outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (2003). 2012;52:838–50.

    Google Scholar 

  31. Cranor CW, Bunting BA, Christensen DB. The Asheville project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (Wash). 2003;43:173–84.

    Google Scholar 

  32. Wishah RA, Al-Khawaldeh OA, Albsoul AM. Impact of pharmaceutical care interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes: Randomized controlled trial. Diabetes Metab Syndr. 2015;9:271–6.

    Google Scholar 

  33. Passarella P, Kiseleva TA, Valeeva FV, et al. Hypertension management in diabetes: 2018 update. Diabetes Spectr. 2018;31:218–24.

    PubMed  PubMed Central  Google Scholar 

  34. Al Mazroui NR, Kamal MM, Ghabash NM, et al. Influence of pharmaceutical care on health outcomes in patients with type 2 diabetes mellitus. Br J Clin Pharmacol. 2009;67:547–57.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Choe HM, Mitrovich S, Dubay D, et al. Proactive case management of high-risk patients with type 2 diabetes mellitus by a clinical pharmacist: a randomized controlled trial. Am J Manag Care. 2005;11:253–60.

    PubMed  Google Scholar 

  36. Santschi V, Chiolero A, Paradis G, et al. Pharmacist interventions to improve cardiovascular disease risk factors in diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabetes Care. 2012;35:2706–17.

    PubMed  PubMed Central  Google Scholar 

  37. Davis CS, Ross LAR, Bloodworth LS. The impact of clinical pharmacist integration on a collaborative interdisciplinary diabetes management team. J Pharm Pract. 2017;30:286–90.

    PubMed  Google Scholar 

  38. Renfro C, Ferreri S, Barber T, et al. Development of a communication strategy to increase interprofessional collaboration in the outpatient setting. Pharmacy (Basel). 2018;6:4.

    PubMed Central  Google Scholar 

  39. Congdon HB, Eldridge BH, Truong H, et al. Development and implementation of a navigator-facilitated care coordination algorithm to improve clinical outcomes of underserved latino patients with uncontrolled diabetes. J Health Care Poor Underserved. 2013;24:1604–13.

    Google Scholar 

  40. Mohamed H, Al-Lenjawi B, Amuna P, et al. Culturally sensitive patient-centred educational programme for self-management of type 2 diabetes: a randomized controlled trial. Prim Care Diabetes. 2013;7:199–206.

    PubMed  Google Scholar 

  41. Cander S, Gül Ö, Gül CB, et al. Re-training of type 2 diabetic patients for better adherence to diabetes care plan in oral anti-diabetics and plus insulin treatment groups. Turk JEM. 2015;19:49–54.

    Google Scholar 

  42. Deters MA, Laven A, Castejon A, et al. Effective interventions for diabetes patients by community pharmacists: A meta-analysis of pharmaceutical care components. Ann Pharmacother. 2018;52:198–211.

    PubMed  Google Scholar 

  43. van Eikenhorst L, Taxis K, van Dijk L, et al. Pharmacist-led self-management interventions to improve diabetes outcomes. A systematic literature review and meta-analysis. Front Pharmacol. 2017;8:891.

    PubMed  PubMed Central  Google Scholar 

  44. Bener A, Abdulmalik M, Al-Kazaz M, et al. Medical audit of the quality of diabetes care: is primary care more successful than hospitals? J Prim Care Community Health. 2012;3:42–50.

    Google Scholar 

  45. Blonde L, Khunti K, Harris SB, et al. Interpretation and impact of real-world clinical data for the practicing clinician. Adv Ther. 2018;35:1763–74.

    PubMed  PubMed Central  Google Scholar 

  46. Mochtar I, Al-Monjed MF. Is diabetes management in primary care improving clinical outcomes? A study in Qatar. East Mediterr Health J. 2015;21:239–45.

    CAS  Google Scholar 

  47. Jahangard-Rafsanjani Z, Sarayani A, Nosrati M, et al. Effect of a community pharmacist-delivered diabetes support program for patients receiving specialty medical care: a randomized controlled trial. Diabetes Educ. 2015;41:127–35.

    PubMed  Google Scholar 

  48. Al AdAwi RM, Stewart D, Ryan C, et al. A systematic review of pharmacist input to metabolic syndrome screening, management and prevention. Int J Clin Pharm. 2020;42:995–1015.

    PubMed  PubMed Central  Google Scholar 

  49. Greenfield S. Making real-world evidence more useful for decision making. Value Heal. 2017;20:1023–4.

    Google Scholar 

  50. Berger ML, Sox H, Willke R, et al. Good practices for real-world data studies of treatment and/or comparative effectiveness: Recommendations from the joint ISPOR-ISPE special task force on real-world evidence in health care decision making. Value Health. 2017;20:1003–1008.

    Google Scholar 

  51. Ye S, Krupka DJ, Davidson KW. Diagnosing medication non-adherence in a patient with myocardial infarction. Front Psychol. 2012;3:267

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors would like to express their sincere thanks to Qatar Petroleum (QP) Health Department and QP Medical Center Dukhan, for providing us with the permission and all the required resources to conduct this project. We would also like to thank all healthcare providers and patients at the diabetes clinic who participated in the study and for sharing their lived experiences in Phase 2 of the study.

Funding

The authors acknowledge Qatar University for funding the research through the Office of Research Support grant numbers QUST-2-CPH-2019-1 and QUST-2-CPH-2018-12.

Author information

Authors and Affiliations

  1. Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar

    Sara Abdulrhim, Ahmed Awaisu, Mohamed Izham Mohamed Ibrahim, Mohammad Issam Diab & Sowndramalingam Sankaralingam

  2. Qatar Petroleum Diabetes Clinic, Qatar Petroleum Healthcare Center, Dukhan, Qatar

    Mohamed Abdelazim Mohamed Hussain, Hend Al Raey & Mohammed Thahir Ismail

Authors
  1. Sara Abdulrhim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmed Awaisu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohamed Izham Mohamed Ibrahim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohammad Issam Diab
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohamed Abdelazim Mohamed Hussain
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hend Al Raey
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mohammed Thahir Ismail
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sowndramalingam Sankaralingam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sowndramalingam Sankaralingam.

Ethics declarations

Conflicts of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

Qatar Petroleum Health Department and Qatar University Institutional Review Board (QU-IRB) approved the research protocol and and the associated data collection tools (Approval number: QU-IRB 1067-E/19). Confidentiality of patients’ data was maintained, and there was no disclosure of any identifiers. No patient consent was required in this study as it involved retrospective data collection without any patient interaction.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 128 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abdulrhim, S., Awaisu, A., Ibrahim, M.I.M. et al. Impact of pharmacist-involved collaborative care on diabetes management in a primary healthcare setting using real-world data. Int J Clin Pharm 44, 153–162 (2022). https://doi.org/10.1007/s11096-021-01327-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-021-01327-x

Keywords

Search

Navigation