Glycemic control through pharmaceutical care: a meta-analysis of randomized controlled trials

Abstract

Objectives To evaluate the effect of pharmaceutical care (PC) on glycemic control in patients with type 2 diabetes mellitus. Methods A systematic search of literature was conducted to identify randomized controlled trials (RCTs) in patients with type 2 diabetes mellitus. RCTs published in English between January 2011 and November 2015 were identified using nine electronic databases: MEDLINE, International Pharmaceutical Abstracts (IPA), EMBASE, Scopus, Science Direct, Cochrane Library, Web of Science, Springer Link, and Google Scholar. Studies were included if they outlined a pharmaceutical care intervention conducted by pharmacists alone or in collaboration with other health care professional(s). The studies were identified and data was extracted independently by two reviewers. The meta‐analysis was conducted by using RevMan version 5.3. A random‐effects model was used to calculate the standard mean difference (SMD) with a 95% confidence interval in glycosylated haemoglobin (HbA1C) levels. Key findings Thirteen RCTs outlining PC interventions in type 2 diabetes mellitus patients (n = 1828) were included. The interventions included care plan development, medication reviews, patient education and counselling of patients with follow‐up. All RCTs reported statistically significant reductions in HbA1c in the intervention group (SMD = −0.97; 95% CI −1.21 to −0.73; P = 0.00001) as compared to the control group. Significant heterogeneity in SMD (χ2 = 68.96) was observed. Conclusions The findings suggest that PC interventions are effective (at least in short‐term follow‐up in hospital setting) in reducing HbA1c levels in patients with type 2 diabetes mellitus. Pharmacists, working alone or in collaboration with other health professionals have significant impact on improving the health status of patients with type 2 diabetes mellitus.

The role of community pharmacists and their position in the delivery of diabetes care: an update for medical professionals

“…Despite varied settings, healthcare models and population groups, several systematic reviews have demonstrated the favourable impact community pharmacy interventions have on both clinical and patient-related outcomes (online supplementary table 2). 27–35…”

“…The duration of interventions has typically ranged from 3 months to 12 months, while the follow-up period has ranged from 1 month to 4 years 35 37. There is conflicting evidence as to whether duration predicts effect32 34 35 but it has been proposed that frequency of contact is most important 39…”