Background
The role of a pharmacist in primary health care settings of Pakistan is still obscure. Thus, we aimed to demonstrate the pharmacist-led improvements in glycemic, blood pressure and lipid controls in type 2 diabetes mellitus (T2DM) patients of Lahore, Pakistan.
Methods
The first open label, randomized control trial conducted at a primary health care facility of Lahore, Pakistan by enrolling 244 uncontrolled type 2 diabetes (hemoglobin A1 c, (HbA1c); 10.85 ± 1.74) patients. The pharmacological intervention included identification of drug related problems, drug interactions, change in dose, frequency and therapy switches in collaboration with physician, while non-pharmacological intervention consisted of diet, lifestyle and behavior counseling. Outcome measures were glycemic (HbA1c), blood pressure and lipid controls.
Results
In intra-group comparison, compared to control arm (
C
,
n
= 52), subjects in the intervention arm (
I
,
n
= 83) demonstrated significant differences in process outcome measures; baseline vs final, such as HbA1c (
C
; 10.3 ± 1.3 vs 9.7 ± 1.3,
p
< 0.001,
I
; 10.9 ± 1.7 vs 7.7 ± 0.9,
p
< 0.0001), systolic blood pressure (SBP) (
C
; 129.9 ± 13.9 vs 136 ± 7.1,
p
= 0.0001,
I
; 145 ± 20.4 vs 123.9 ± 9.9 mmHg,
p
< 0.0001), diastolic blood pressure (DBP) (
C
; + 4,
p
= 0.03,
I
; − 7 mmHg,
p
< 0.0001), cholesterol (
C
; 235.8 ± 57.7 vs 220.9 ± 53.2,
p
= 0.15,
I
; 224 ± 55.2 vs 153 ± 25.9 mg/dL,
p
< 0.0001), triglycerides (
C
; 213.2 ± 86.6 vs 172.4 ± 48.7,
p
= 0.001,
I
; 273 ± 119.4 vs 143 ± 31.6 mg/dL,
p
< 0.0001) and estimated glomerular filtration rate (eGFR) (
C
; 77.5 ± 18.6 vs 76 ± 14.2,
p
= 0.5,
I
; 69.4 ± 21.3 vs 93.8 ± 15.2 ml/min/1.73m
2
,
p
< 0.0001). Likewise, inter-group improvements were more significant in the subjects of intervention group at final follow up in comparison to control for various process outcome measures; HbA1c (
p
< 0.001), SBP (
p
< 0.0001), DBP (
p
= 0.02), cholesterol (
p
< 0.0001), triglycerides (
p
< 0.0001), SCr (
p
< 0.001), eGFR (
p
...
