Impact of pharmacist-led education on knowledge, adherence, and glycaemic control of type 2 diabetic outpatients
DOI:
https://doi.org/10.46542/pe.2022.221.795804Keywords:
Blood glucose, Compliance, Diabetes, Medication therapy managementAbstract
Objectives: This study aimed to evaluate the effect of a pharmacist-led education programme on knowledge, adherence, and glycaemic control of type 2 diabetic outpatients.
Methods: A prospective cohort study was conducted among adult type 2 diabetes mellitus (DM) outpatients. The pharmacist-led education programme was delivered to patients and their family members. Patient knowledge and adherence were assessed using questionnaires. Plasma glucose levels were also monitored during the study.
Results: 26 patients completed the study (median (IQR) age 61.5 (58.3 – 65.0) years, female 57.7%, median (IQR) duration of DM 5.0 (3.0 – 15.0) years). At the end of study, the education programme improved patient’s knowledge by 19.2% (p = 0.409) and medication adherence by 46.1% (p = 0.002). Glycaemic control in fasting plasma and postprandial glucose levels were achieved in 19.2% and 23.1% of patients, respectively.
Conclusion: An education programme led by pharmacists may improve diabetic outpatient’s knowledge, adherence to therapy, and glycaemic control.
References
Al-Azzam, S.I., Alzoubi, K.H., Aburuz, S., & Alefan, Q. (2016). Drug-related problems in a sample of outpatients with chronic diseases: A cross-sectional study from Jordan. Therapeutics and Clinical Risk Management, 12, 233–9
Al Assaf, S., Zelko, R., & Hanko, B. (2022). The effect of interventions led by community pharmacists in primary care for adults with type 2 diabetes mellitus on therapeutic adherence and HbA1c levels: a systematic review. International Journal of Environmental Research and Public Health, 19(6188), 1–16
Bordonaro, S., Romano, F., Lanteri, E., Cappuccio, F., Indorato, R., Butera, A., D'Angelo, A., Ferraù, F., & Tralongo, P. (2014). Effect of a structured, active, home-based cancer-treatment program for the management of patients on oral chemotherapy. Patient preference and adherence, 8, 917–923. https://doi.org/10.2147/PPA.S62666
Bukhsh, A., Khan, T.M., Phisalprapa, P., Duangjai, A., Saokaew, S., Nawaz, M. S., Ahmed, H. S., & Goh, B-.H. (2022). Impact of pharmacist-led diabetes self-care education on patients with type 2 diabetes in Pakistan: a randomized controlled trial. Frontiers in Pharmacology, 13(February), 1–9. https://doi.org/10.3389/fphar.2022.754999
Bukhsh, A., Tan, X.Y., Chan, K.G., Lee, L.H., Goh, B.H., & Khan, T.M. (2018). Effectiveness of pharmacist-led educational interventions on self-care activities and glycemic control of type 2 diabetes patients: A systematic review and meta-analysis. Patient Preference and Adherence, 12, 2457–74
Collins, C., Limone, B.L., Scholle, J.M., & Coleman, C.I. (2011). Effect of pharmacist intervention on glycemic control in diabetes. Diabetes Research and Clinical Practice, 92(2), 145–152
David, E.A., Soremekun, R.O., Abah, I. O., & Aderemi-Williams, R.I. (2021). Impact of pharmacist-led care on glycaemic control of patients with uncontrolled type 2 diabetes: a randomised controlled trial in Nigeria. Pharmacy Practice, 19(3), 2402
Delage, C., Lelong, H., Brion, F., & Blacher, J. (2021). Effect of a pharmacist-led educational intervention on clinical outcomes: A randomised controlled study in patients with hypertension, type 2 diabetes and hypercholesterolaemia. European Journal of Hospital Pharmacy, 28(e1)
Ebid, A.-H.I., Mobarez, M.A., Ramadan, R.A., & Mahmoud, M.A. (2022). Impact of a clinical pharmacist intervention program on the follow-up of type-2 diabetic patients. Hospital Pharmacy, 57(1), 76–82
van Eikenhorst, L., Taxis, K., van Dijk, L., & de Gier, H. (2017). Pharmacist-led self-management interventions to improve diabetes outcomes. A systematic literature review and meta-analysis. Frontiers in Pharmacology, 8, 891
von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., Gøtzsche, P.C., Vandenbroucke, J.P., & STROBE Initiative (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bulletin of the World Health Organization, 85(11), 867–872. https://doi.org/10.2471/blt.07.045120
Erku, D.A., Ayele, A.A., Mekuria, A.B., Belachew, S.A., Hailemeskel, B., & Tegegn, H.G. (2017). The impact of pharmacist-led medication therapy management on medication adherence in patients with type 2 diabetes mellitus: A randomized controlled study. Pharmacy Practice, 15(3), 1–7
Farland, M.Z., Byrd, D.C., Shawn McFarland, M., Thomas, J., Franks, A.S., George, C.M., Gross, B.N., Cassidy, R., & Morgan, T. (2013). Pharmacist-physician collaboration for diabetes care: the diabetes initiative program. Annals of Pharmacotherapy, 47(6), 781–9
Farsaei, S., Sabzghabaee, A. M., Zargarzadeh, A. H., & Amini, M. (2011). Effect of pharmacist-led patient education on glycemic control of type 2 diabetics: A randomized controlled trial. Journal of Research in Medical Sciences, 16(1), 43–49
Gregg, E., Buckley, J., Ali, M., Davies, J., Flood, D., Griffiths, B., Lim, L.-L.,Manne-Goehler, J., Pearson-Stuttard, J., & Shaw, J. (2021). Improving health outcomes of people with diabetes mellitus: target setting to reduce the global burden of diabetes mellitus by 2030. Glennis Andall-Brereton
Hughes, J.D., Wibowo, Y., Sunderland, B., & Hoti, K. (2017). The role of the pharmacist in the management of type 2 diabetes: current insights and future directions. Integrated Pharmacy Research and Practice, 6, 15–27
Ligita, T., Wicking, K., Francis, K., Harvey, N., & Nurjannah, I. (2019). How people living with diabetes in Indonesia learn about their disease: A grounded theory study. PLoS ONE, 14(2), 1–19
Lun Gan, J.K., Brammer, J.D., & Creedy, D.K. (2011). Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with type 2 diabetes: a systematic review. JBI Library of Systematic Reviews, 9(9), 269–312
Malathy, R., Narmadha, M.P., Ramesh, S., Alvin, J.M., & Dinesh, B.N. (2011). Effect of a diabetes counseling programme on knowledge, attitude and practice among diabetic patients in Erode district of South India. Journal of Young Pharmacists, 3(1), 65–72
McPherson, M.L., Smith, S.W., Powers, A., & Zuckerman, I.H. (2008). Association between diabetes patients’ knowledge about medications and their blood glucose control. Research in Social and Administrative Pharmacy, 4(1), 37–45
Mehuys, E., Van Bortel, L., De Bolle, L., Van Tongelen, I., Annemans, L., Remon, JP., & Giri, M. (2011). Effectiveness of a community pharmacist intervention in diabetes care: A randomized controlled trial. Journal of Clinical Pharmacy and Therapeutics, 36(5), 602–613
Ministry of Health. (2018). Riset Kesehatan Dasar (Basic Health Survey) 2018. Badan Penelitian dan Pengembangan Kesehatan (National Centre for Health Research and Development), Kementerian Kesehatan (Ministry of Health), Republic of Indonesia. Jakarta
Ngcobo, S., & Rossouw, T. (2022). Acceptability of home-based HIV care offered by community health workers in Tshwane District, South Africa: a survey. AIDS Patient Care and STDs, 36(2), 55–63
Pamungkas, R.A., Chamroonsawasdi, K., & Vatanasomboon, P. (2017). A systematic review: Family support integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behavioral Sciences, 7(3), 1–17
Pousinho, S., Morgado, M., Falcão, A., & Alves, G. (2016). Pharmacist interventions in the management of type 2 diabetes mellitus: A systematic review of randomized controlled trials. Journal of Managed Care and Specialty Pharmacy, 22(5), 493–515
Rudijanto, A., Soewondo, P., Waspadji, S., Yunir, E., & Purnamasari, D. (2011). The Indonesian Society of Endocrinology’s summary article of diabetes mellitus national clinical practice guidelines. Journal of the ASEAN Federation of Endocrine Societies, 26(1), 17–19
Seuring, T., Marthoenis, Rhode, S., Rogge, L., Rau, H., Besançon, S., Zufry, H., Sofyian, H., & Vollmer, S. (2019). Using peer education to improve diabetes management and outcomes in a low-income setting: A randomized controlled trial. Trials, 20(1), 1–8
Soelistijo, S.A., Novida, H., Rudijanto, A., Soewondo, P., Suastika, K., Manaf, A., Sanusi, H., Lindarto, D., Shahab, A., Pramono, B., Langi Y.A., Purnamasari, D., Soetedjo, N.N., Saraswati, M.R., Dwipayana, M.P., Yuwono, A., Sasiarini, L., Sugiarto, Sucipto, K.W., & Zufry, H. (2015). Konsensus pengendalian dan pencegahan diabetes melitus tipe 2 di Indonesia (Consensus in controlling and preventing type 2 diabetes mellitus in Indonesia). Perkumpulan Endokrinologi Indonesia (Indonesian Society of Endocrinology). Jakarta
Story, A., Aldridge, R. W., Smith, C. M., Garber, E., Hall, J., Ferenando, G., Possas, L., Hemming, S., Wurrie, F., Luchenski, S., Abubakar, I., McHugh, T.D., White, P.J., Watson, J.M., Lipman, M., Garfein, R., & Hayward, A.C. (2019). Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. The Lancet, 393(10177), 1216–1224
Suprapti, B., Izzah, Z., Nugroho, C.W., & Andarsari, M.R. (2018). Factors related to the incidence of drug-related problems and achievement of therapeutic targets among type 2 diabetic outpatients: a research report. Surabaya
Suprapti, B., Vilaningtyas, N., Nilamsari, W.P., & Ichwani, J. (2014). Blood glucose target achievement and antidiabetes regimen in type-2 diabetic geriatric patients. Indonesian Journal of Pharmacy, 25(2), 98–104
Suprapti, B., Widyasari, N., Rahmadi, M., & Wibisono, C. (2017). Review of insulin therapy in type 2 diabetes mellitus ambulatory patients. Indonesian Journal of Pharmacy, 28(4), 221–231
Svarstad, B.L., Chewning, B.A., Sleath, B.L., & Claesson, C. (1999). The Brief Medication Questionnaire : A tool for screening patient adherence and barriers to adherence. Patient Education and Counseling, 37, 113–124
Widayanti, A.W., Heydon, S., Green, J.A., & Norris, P. (2021). Effectiveness of an intensive community-based intervention for people with type 2 diabetes in Indonesia: A pilot study. Diabetes Research and Clinical Practice, 181, 109087.
Williams, R., Karuranga, S., Malanda, B., Saeedi, P., Basit, A., Besançon, S., Bommer, C., Esteghamati, A., Ogurtsova, K., Zhang, P., & Colagiuri, S. (2020). Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes research and clinical practice, 162, 108072. https://doi.org/10.1016/j.diabres.2020.108072
Withidpanyawong, U., Lerkiatbundit, S., & Saengcharoen, W. (2019). Family-based intervention by pharmacists for type 2 diabetes: a randomised controlled trial. Patient Education and Counseling, 102(1), 85–92