A pilot study of Pharmacist-Dietician Collaborative support and Advice (PDCA) for patients with type 2 diabetes in community pharmacy: A single-arm, pre-post study

Abstract

Background: In Japan, there is a pressing need to improve community health care to cope with the rapid aging of the population. In this context, there have been private-sector-led approaches to enhance community dietary support by employing dietitians in pharmacies. Objectives: To evaluate the effects of collaboration between dietitians and pharmacists working in pharmacies to support patients with type 2 diabetes. Methods: A single group pre- and post-comparative study was conducted on patients with type 2 diabetes mellitus. The intervention period was 6 months. During the intervention period, the dietitians provided dietary support to the patients after first providing them with medication guidance. The contents of these instructions were shared with the pharmacists. The contents of the instructions were recorded, and confirmed in monthly meetings with the principal investigator. The primary endpoint was the Hemoglobin A1c(HbA1c) level, and the secondary endpoints were high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), Triglyceride (TG), degree of dietary self-management, degree of unbalanced diet and satisfaction with pharmacy services. Results: Eight patients completed the intervention period. The first patient’s intervention started in March 2021, and all patients’ interventions were completed by December 2021. The primary endpoint, the mean (SD) HbA1c, was 7.26 (0.96) at baseline and decreased to 6.63 (0.79) after 6 months (p=0.028, r=0.72). Also, the HDL-c increased from 55.00 (14.81) to 63.14 (10.11) (p=0.110, r=0.51) and the Diabetes Mellitus Dietary Self Efficacy Scale score increased from 51.67 (8.31) to 60.17 (8.45) (p=0.025, r=0.79) and the patient satisfaction score increased 24.0 (4.0) to 26.1 (3.3) (p=0.161, r=0.51). Moderate decreases were also observed in LDL-c (p=0.235, r=0.47) and TG (p=0.368, r=0.37). Conclusions: Collaboration between dietitians and pharmacists working in pharmacies may improve the dietary habits and glycemic control of patients with type 2 diabetes. To verify this hypothesis more reliably, randomized controlled trials need to be conducted.

A Glycemic Diet Improves the Understanding of Glycemic Control in Diabetes Patients During Their Follow-Up

“…A significant decrease in the HbA1c and a notable decrease in HDL-c levels were observed in collaboration with a pharmacist and a dietician in Type 2 diabetes mellitus patients. The patient counseling provided by the clinical pharmacist can extensively improve the degree of dietary self-management [ 20 ]. The clinical pharmacist can support the nutritionist by conducting an intensive nutrition assessment considering the patient's age, energy expenditure, the medications the patient takes daily, and clinical status to provide the appropriate micronutrients and macronutrients to avoid over- or nutrition orders.…”

A text mining to nutritional counseling and instruction provided by registered dietitians

“…Dietitians also provide a wide range of consultations related to maintaining and promoting health, providing more health support to the community. Collaboration between dietitians and pharmacists working in pharmacies may improve dietary habits [9]. In other words, multidisciplinary cooperation between pharmacists and dietitians is important to establish a higher quality medical contribution to the community.…”

Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room

“…Through examination, it can accurately grasp the patient's condition, and provide certain guidance value for the subsequent clinical development of treatment plans, which is widely recognized by clinical and patient. [1][2][3] Digestive endoscopy mainly combines chemical and electronic staining techniques to observe lesions, not only improving the clarity of observation, but also increasing the detection rate of digestive tract diseases, with a more prominent effect compared to traditional white light endoscopy. [4,5] However, with the promotion and use of gastrointestinal endoscopy, it has been found in practical work that some patients are prone to trigger negative emotions such as tension, fear, and anxiety due to their low understanding of gastrointestinal endoscopy and significant physiological stress reactions, which directly hinder the development of examination work, and have a certain impact on the outcome of diagnosis and treatment, and may even increase the probability of risk events.…”