Bukhsh Allah, Khan Tahir Mehmood, Phisalprapa Pochamana, Duangjai Acharaporn, Saokaew Surasak, Nawaz Muhammad Sarfraz, Ahmed Hafiz Sajjad, Goh Bey-Hing
School of Pharmacy, Monash University, Jalan Lagoon Selatan, Malaysia.
Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan.
Front Pharmacol. 2022 Feb 9;13:754999. doi: 10.3389/fphar.2022.754999. eCollection 2022.
There is a little evidence on efficacy of pharmacy-based interventions on clinical outcomes of type 2 diabetes mellitus (T2DM) patients in Pakistan. To appraise the impact of pharmacist-led self-care education on glycemic control, self-care practices and disease knowledge of T2DM patients with poor glycemic control (HbA1c ≥ 7%). In this 6-months, randomized controlled trial (RCT), = 75, T2DM patients seeking care at a diabetes clinic were randomized in to two groups. Intervention group ( = 38) received two face-to-face educational sessions (at enrollment and on week 12), whereas control group ( = 37) received usual care. Outcome measures such as glycemic control, self-care practices and disease knowledge were assessed at the time of enrollment and after 6-months in both groups. Thirty-three intervention and thirty-three participants from the control group completed the study. Mean glycated hemoglobin (% HbA1c) significantly reduced in the intervention group from 9.00 ± 1.43 to 8.09 ± 1.16 ( < .01). However, no significant change was observed in the control group (9.20 ± 1.24 to 8.93 ± .97; = .06). Cohen's d effect size of the intervention on HbA1c was .78. Percentage of participants achieving glycemic control (HbA1c < 7%) were significantly higher ( < .05) in the intervention group as compared to the control group (twenty-four vs. six), after 6 months of the trial. A significant ( < .01) improvement in mean scores for disease knowledge and self-care activities was also observed in the intervention group participants, whereas no significant improvements ( > .05) were observed in the control group. The study demonstrated an improvement in glycemic control, disease knowledge and self-care activities of T2DM patients who received pharmacist-led educational intervention. The study findings support clinical significance of integrating pharmacy-based interventions in diabetes management.
关于在巴基斯坦，以药房为基础的干预措施对2型糖尿病（T2DM）患者临床结局的疗效，几乎没有相关证据。为了评估药师主导的自我护理教育对血糖控制不佳（糖化血红蛋白[HbA1c]≥7%）的T2DM患者的血糖控制、自我护理实践及疾病知识的影响。在这项为期6个月的随机对照试验（RCT）中，75例在糖尿病诊所就诊的T2DM患者被随机分为两组。干预组（n = 38）接受两次面对面教育课程（在入组时和第12周），而对照组（n = 37）接受常规护理。在两组入组时和6个月后评估血糖控制、自我护理实践及疾病知识等结局指标。干预组33例和对照组33例参与者完成了研究。干预组糖化血红蛋白平均水平（% HbA1c）从9.00±1.43显著降至8.09±1.16（P <.01）。然而，对照组未观察到显著变化（从9.20±1.24至8.93±.97；P =.06）。干预对HbA1c的Cohen's d效应量为0.78。试验6个月后，干预组实现血糖控制（HbA1c < 7%）的参与者百分比显著高于对照组（24例对6例，P <.05）。干预组参与者的疾病知识和自我护理活动平均得分也有显著（P <.01）改善，而对照组未观察到显著改善（P>.05）。该研究表明，接受药师主导教育干预的T2DM患者的血糖控制、疾病知识和自我护理活动有所改善。研究结果支持在糖尿病管理中纳入以药房为基础的干预措施的临床意义。
