Pharmacist contributions in the treatment of diabetes mellitus in Southeast Asia: a narrative review

Abstract

BackgroundThe growing burden of diabetes mellitus (DM) in Southeast Asia puts pharmacists in the ideal position to provide management of DM. This narrative review aims to describe the evidence of pharmacist contribution in improving DM in Southeast Asia.ContentA literature search was conducted to identify relevant research articles published from 2010 to 2018 in four databases (Scopus, Pubmed, MEDLINE, and Springerlink) describing pharmacist roles and activities intended to improve management of DM in Southeast Asian countries. Results were synthesized narratively and divided into three main sections: (1) the role of pharmacist in DM management, (2) the impact of pharmacist role, and (3) the barriers to the implementation of services in DM management. A total of 16 studies were identified, of which ten studies mentioned services that were conducted exclusively by a pharmacist and the remaining collaborated with other health professionals. A number of pharmacist services were reported including prevention, dispensing, medication review, drug information services, patient counselling and education, monitoring, follow-up, and referral. Barriers related to individual, organizational, and public recognition were described.Summary and outlookThe Pharmacist can contribute to improve DM management in a variety of settings. Action research on pharmacist intervention in DM is recommended.

Understandings, Attitudes, and Barriers About Diabetes Care: Analysis of Factors Influencing Community Pharmacists in China

“…A systematic review of pharmacies in South Asia showed that training is needed in the process of identifying pharmaceutical care problems because pharmacists are lacking experience in identifying and tackling care issues. 15 Therefore, relevant government departments should combine the current situation to refine licensed pharmacists and regulations, and coordinate resources to provide a suitable environment. Given respondents’ major, more and more students majoring in pharmacy and traditional medicine contribute to a specialized service team from a forward-looking perspective.…”

“…12 Pharmacists can play the following roles in the comprehensive management of diabetic patients, including improving patient medication compliance, ensuring the rationality of patients' home medication, providing medication education for patients, and participating in medication monitoring for diabetic patients. [13][14][15] Study results from primary literature have shown that the involvement of pharmacists in direct patient care yields additional average HbA1c reductions of 0.88%-1.8%, average systolic blood pressure reductions of 5.7-7.8 mmHg, and average low-density lipoprotein (LDL) reductions of 6.3 mg/dL-18.7 mg/dl, compared with standard care. 16,17 Also, the continuous intervention of the pharmacist is a cost-effective administration method, which improved the quality of life without any increase in spending.…”

“…Similar screening tools are promoting in Western, Oman, India, Japan. 15 In China, around 400,000 pharmacists practice in community pharmacies. 4 Not restricted in the traditional model, community pharmacists can also play a significant role in raising community awareness on risk factors and the importance of a healthy lifestyle.…”

Intervention by clinical pharmacists can improve blood glucose fluctuation in patients with diabetes and acute myocardial infarction: A propensity score‐matched analysis

“…Clinical pharmacists provide several clinical pharmacy services to promote the rational use of medications in diabetic patients, inducing a thorough evaluation of the patient status, providing suggestions on drug treatment to physicians, delivering relevant education to patients. 9,10 Compared to the usual care regime, pharmacist interventions have resulted in favorable improvements in the blood glucose indices including hemoglobin A1c (HbA1c), and fasting blood glucose (FBG), as well as other cardiovascular risk factors involving blood pressure, body mass index (BMI), total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides. 11 However, evidence supporting the effects of clinical pharmacist interventions on the blood glucose fluctuations are limited.…”

Medication Adherence of Persons with Type 2 Diabetes in Malaysia: A Scoping Review and Meta-Analysis

“…5 A recent systematic review of DMTAC studies from Southeast Asia conducted by Dwiputri et al, concluded that pharmacists can contribute to improve diabetes management in a variety of settings. 6 Of the 16 articles included in the above review, half (8 studies) came from Malaysia. 6 …”