Background: Diabetes mellitus is highly prevalent in the Middle East and the burden associated with it is dramatically increasing. Pharmacists working in collaborative healthcare teams have an important role to improve outcomes in the primary care of diabetes. Objectives: To evaluate the impact of a collaborative pharmaceutical care service (CPCS) on improving outcomes among patients with diabetes in a primary care setting. Methods: This was a retrospective, multiple time series study involving patients attending an ambulatory diabetes clinic at Qatar Petroleum Healthcare Center in Dukhan, Qatar. Patients' glycated hemoglobin A 1c , fasting plasma glucose, body mass index, systolic blood pressure, diastolic blood pressure, and lipid profile were obtained at baseline, 6 months, and 12 months of receiving CPCS through a retrospective chart review. A repeatedmeasures analysis of variance test was used to determine the impact of the intervention on clinical outcomes. Results: Ninety-six patients with diabetes were included in the analyses. There was a statistically significant reduction (ie, improvement) in glycated hemoglobin A 1c by 1.4%, fasting plasma glucose by 41.3 mg/dL, body mass index by 1 kg/m 2 , systolic blood pressure by 14.9 mm Hg, and diastolic blood pressure by 8.7 mm Hg from baseline to 12 months (P<.001 for all). Nevertheless, no significant reductions were observed in the lipid profile. Conclusions: CPCS provision improves clinical outcomes in patients with diabetes over a 12-month follow-up period in a primary healthcare setting. Future studies should determine the long-term impact of a collaborative care model in this setting.
Background
Diabetes mellitus is highly prevalent and associated with huge economic burden globally. The conventional care and management of diabetes mellitus is highly fragmented and complex, warranting the need for a comprehensive Collaborative Care Model (CCM). Little is known about the perception of patients with diabetes and their healthcare providers about CCM, its barriers and facilitators. This study aimed to explore the value of CCM in diabetes care at a primary healthcare (PHC) setting from the perspective of patients with diabetes and healthcare professionals (HCPs), in an effort to expand our current knowledge on collaborative care in diabetes at primary care level for the purpose of quality improvement and service expansion.
Methods
Using an exploratory case study approach, semi-structured interviews were conducted among patients and HCPs who encountered CCM in Qatar during 2019 and 2020. The semi-structured interviews were transcribed verbatim and the data were analysed and interpreted using a deductive-inductive thematic analysis approach.
Results
Twelve patients and 12 HCPs at a diabetes clinic participated in one-to-one interviews. The interviews resulted in five different themes: the process and components of collaborative care model (four subthemes), current organizational support and resources (three subthemes), impact of collaborative care model on diabetes outcomes (three subthemes), enablers of collaborative care model (three subthemes), and barriers to collaborative care model (three subthemes). The participants indicated easy access to and communication with competent and pleasant HCPs. The patients appreciated the extra time spent with HCPs, frequent follow-up visits, and health education, which empowered them to self-manage diabetes. HCPs believed that successful CCM provision relied on their interest and commitment to care for patients with diabetes. Generally, participants identified barriers and facilitators that are related to patients, HCPs, and healthcare system.
Conclusions
The providers and users of CCM had an overall positive perception and appreciation of this model in PHC settings. Barriers to CCM such as undesirable attributes of HCPs and patients, unsupportive hospital system, and high workload must be addressed before implementing the model in other PHC settings.
Background: Diabetes mellitus (DM) is one of the top health priorities in Qatar due to its high prevalence of 15.5%, which is projected to increase to 29.7% by 2035. DM management is still challenging despite healthcare advancement, warranting the need for a comprehensive Collaborative Care Model (CCM). Therefore, we aim to evaluate the value of CCM in DM care at a primary healthcare (PHC) setting in Qatar. Methodology: This study was a qualitative exploration of healthcare professionals’ (HCPs’) and patients’ perspectives on the value of CCM provided at the center. Twelve patients and twelve HCPs participated in semi-structured one-toone interviews. Qualitative data were analyzed and interpreted using a deductive coding thematic analysis process. Results: The interviews resulted in 14 different themes under the predefined domains: components of CCM (five themes), the impact of CCM (three themes), facilitators of CCM provision (three themes), and barriers of CCM provision (three themes). The majority of the participants indicated easy access to and communication with HCPs at QPDC. Participants appreciated the extra time spent with HCPs, frequent follow-up visits, and health education, which empowered them to self-manage DM. Generally, participants identified barriers and facilitators related to patients, HCPs, and healthcare system. Conclusion: The providers and users of CCM had an overall positive perception and appreciation of this model in PHC settings. Barriers to CCM such as unpleasant attitude and undesirable attributes of HCPs and patients, unsupportive hospital system, and high workload must be addressed before implementing the model in other PHC settings.
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