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- Title
Pharmaceutical care of elderly patients with poorly controlled type 2 diabetes mellitus: a randomized controlled trial.
- Authors
Chen, Jyun-Hong; Ou, Huang-Tz; Lin, Tzu-Chieh; Lai, Edward; Yang Kao, Yea-Huei; Lai, Edward Chia-Cheng; Kao, Yea-Huei Yang
- Abstract
<bold>Background: </bold>Care of the elderly with diabetes is more complicated than that for other age groups. The elderly and/or those with multiple comorbidities are often excluded from randomized controlled trials of treatments for diabetes. The heterogeneity of health status of the elderly also increases the difficulty in diabetes care; therefore, diabetes care for the elderly should be individualized. Motivated patients educated about diabetes benefit the most from collaborating with a multidisciplinary patient-care team. A pharmacist is an important team member by serving as an educator, coach, healthcare manager, and pharmaceutical care provider.<bold>Objective: </bold>To evaluate the effects of pharmaceutical care on glycemic control of ambulatory elderly patients with type 2 diabetes.<bold>Setting: </bold>A 421-bed district hospital in Nantou City, Taiwan.<bold>Method: </bold>We conducted a randomized controlled clinical trial involving 100 patients with type 2 diabetes with poor glycemic control (HbA1c levels of ≥9.0 %) aged ≥65 years over 6 months. Participants were randomly assigned to a standard-care (control, n = 50) or pharmaceutical-care (intervention, n = 50) group. Pharmaceutical care was provided by a certified diabetes-educator pharmacist who identified and resolved drug-related problems and established a procedure for consultations pertaining to medication. The Mann–Whitney test was used to evaluate nonparametric quantitative data. Statistical significance was defined as P < 0.05.<bold>Main Outcome Measure: </bold>The change in the mean HbA1c level from the baseline to the next level within 6 months after recruiting.<bold>Results: </bold>Nonparametric data (Mann–Whitney test) showed that the mean HbA1c level significantly decreased (0.83 %) after 6 months for the intervention group compared with an increase of 0.43 % for the control group (P ≤ 0.001). Medical expenses between groups did not significantly differ (−624.06 vs. −418.7, P = 0.767). There was no significant difference in hospitalization rates between groups.<bold>Conclusion: </bold>The pharmacist intervention program provided pharmaceutical services that improved long-term, safe control of blood sugar levels for ambulatory elderly patients with diabetes and did not increase medical expenses.
- Subjects
ELDER care; PHARMACEUTICAL services; TYPE 2 diabetes; PHARMACISTS; PHARMACY research
- Publication
International Journal of Clinical Pharmacy, 2016, Vol 38, Issue 1, p88
- ISSN
2210-7703
- Publication type
journal article
- DOI
10.1007/s11096-015-0210-4