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Evaluation of a pharmacist-managed diabetes medication therapy adherence clinic.

Lim PC, Lim K - Pharm Pract (Granada) (2010)

Bottom Line: A mean reduction in HbA1c of 1.73% (p<0.001), mean reduction in FBG of 2.65mmol/l (p=0.01) and mean reduction in LDL cholesterol of 0.38mmol/l (p=0.007) were achieved.The difference in TG and HDL cholesterol were not significant.The pharmacist-managed DMTAC program resulted in significant improvements in HbA1c, glucose and LDL cholesterol levels as well as medication adherence in patients with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Hospital Pulau Pinang. Penang ( Malaysia ).

ABSTRACT

Unlabelled: Patient adherence to prescribed medication regimens is important in diabetes care to prevent or delay microvascular and macrovascular complications such as retinopathy, nephropathy and myocardial infarction. In Penang Hospital, Malaysia, pharmacists collaborate with physicians in diabetes care through a pharmacist-managed Diabetes Medication Therapy Adherence Clinic (DMTAC) in the Endocrine Clinic, in operation since 2006.

Objective: To evaluate the effectiveness of the pharmacist-managed DMTAC program in improving glycaemic control, lipid parameters and patients' medication adherence.

Method: A retrospective study among patients enrolled in the DMTAC program was conducted between September 2007 and December 2008. Data was included from patients with a glycosylated haemoglobin (HbA1c) >8% and who had completed eight visits with the pharmacists. Medical records and DMTAC forms that provided patients' demographics, medication regimens, adherence and laboratory parameters as well as pharmacists' interventions were reviewed. HbA1c, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL), triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were evaluated. Documented data of patients' adherence to medication regimen [Modified Morisky Medication Adherence Score (MMMAS); high adherence if score >8, medium adherence if score 6 to <8 and low adherence if score <6] was also evaluated.

Results: A total of 43 patients (53.5% females; 46.5% Malays, 44.2% Chinese and 9.3% Indians) were included in the analysis. A mean reduction in HbA1c of 1.73% (p<0.001), mean reduction in FBG of 2.65mmol/l (p=0.01) and mean reduction in LDL cholesterol of 0.38mmol/l (p=0.007) were achieved. The difference in TG and HDL cholesterol were not significant. Patients' adherence to medication regimens improved significantly with an increase in the mean MMMAS score from 7.00 to 10.84 (p<0.001) after completion of the DMTAC program.

Conclusion: The pharmacist-managed DMTAC program resulted in significant improvements in HbA1c, glucose and LDL cholesterol levels as well as medication adherence in patients with diabetes.

No MeSH data available.


Related in: MedlinePlus

Percentage of Patients with a specified reduction in HBA1c
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Figure 3: Percentage of Patients with a specified reduction in HBA1c

Mentions: The mean pre- and post-intervention outcome measures are shown in Table 2. There was a significant difference of -1.73% for mean HbA1c, which decreased from 10.82 (SD=0.31) to 9.09 (SD=0.24) (p<0.001). Twenty-six patients (61%) had achieved at least 1% drop in HbA1c after completion of the DMTAC program (Figure 3). The reduction of 2.65 mmol/l (p=0.011) in mean FBG was also significant. Mean LDL cholesterol also reduced significantly by 0.38 mmol/l (p=0.007). However, reduction of mean TG was not significant. There was a reduction of mean HDL cholesterol but the reduction of 0.05 mmol/l (p=0.333) was not significant. Patient adherence improved significantly with mean MMMAS increasing from medium adherence, 7.00 (SD=0.61) to high adherence, 10.84 (SD=0.10) (p<0.001). After the intervention, 100% of the patients were high adherence.


Evaluation of a pharmacist-managed diabetes medication therapy adherence clinic.

Lim PC, Lim K - Pharm Pract (Granada) (2010)

Percentage of Patients with a specified reduction in HBA1c
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127064&req=5

Figure 3: Percentage of Patients with a specified reduction in HBA1c
Mentions: The mean pre- and post-intervention outcome measures are shown in Table 2. There was a significant difference of -1.73% for mean HbA1c, which decreased from 10.82 (SD=0.31) to 9.09 (SD=0.24) (p<0.001). Twenty-six patients (61%) had achieved at least 1% drop in HbA1c after completion of the DMTAC program (Figure 3). The reduction of 2.65 mmol/l (p=0.011) in mean FBG was also significant. Mean LDL cholesterol also reduced significantly by 0.38 mmol/l (p=0.007). However, reduction of mean TG was not significant. There was a reduction of mean HDL cholesterol but the reduction of 0.05 mmol/l (p=0.333) was not significant. Patient adherence improved significantly with mean MMMAS increasing from medium adherence, 7.00 (SD=0.61) to high adherence, 10.84 (SD=0.10) (p<0.001). After the intervention, 100% of the patients were high adherence.

Bottom Line: A mean reduction in HbA1c of 1.73% (p<0.001), mean reduction in FBG of 2.65mmol/l (p=0.01) and mean reduction in LDL cholesterol of 0.38mmol/l (p=0.007) were achieved.The difference in TG and HDL cholesterol were not significant.The pharmacist-managed DMTAC program resulted in significant improvements in HbA1c, glucose and LDL cholesterol levels as well as medication adherence in patients with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Hospital Pulau Pinang. Penang ( Malaysia ).

ABSTRACT

Unlabelled: Patient adherence to prescribed medication regimens is important in diabetes care to prevent or delay microvascular and macrovascular complications such as retinopathy, nephropathy and myocardial infarction. In Penang Hospital, Malaysia, pharmacists collaborate with physicians in diabetes care through a pharmacist-managed Diabetes Medication Therapy Adherence Clinic (DMTAC) in the Endocrine Clinic, in operation since 2006.

Objective: To evaluate the effectiveness of the pharmacist-managed DMTAC program in improving glycaemic control, lipid parameters and patients' medication adherence.

Method: A retrospective study among patients enrolled in the DMTAC program was conducted between September 2007 and December 2008. Data was included from patients with a glycosylated haemoglobin (HbA1c) >8% and who had completed eight visits with the pharmacists. Medical records and DMTAC forms that provided patients' demographics, medication regimens, adherence and laboratory parameters as well as pharmacists' interventions were reviewed. HbA1c, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL), triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were evaluated. Documented data of patients' adherence to medication regimen [Modified Morisky Medication Adherence Score (MMMAS); high adherence if score >8, medium adherence if score 6 to <8 and low adherence if score <6] was also evaluated.

Results: A total of 43 patients (53.5% females; 46.5% Malays, 44.2% Chinese and 9.3% Indians) were included in the analysis. A mean reduction in HbA1c of 1.73% (p<0.001), mean reduction in FBG of 2.65mmol/l (p=0.01) and mean reduction in LDL cholesterol of 0.38mmol/l (p=0.007) were achieved. The difference in TG and HDL cholesterol were not significant. Patients' adherence to medication regimens improved significantly with an increase in the mean MMMAS score from 7.00 to 10.84 (p<0.001) after completion of the DMTAC program.

Conclusion: The pharmacist-managed DMTAC program resulted in significant improvements in HbA1c, glucose and LDL cholesterol levels as well as medication adherence in patients with diabetes.

No MeSH data available.


Related in: MedlinePlus