Safe and effective use of medicines for patients with type 2 diabetes – A randomized controlled trial of two interventions delivered by local pharmacies

Kjeldsen, Lene Juel; Bjerrum, Lars; Dam, Pernille; Larsen, Bente Overgaard; Rossing, Charlotte; Søndergaard, Birthe; Herborg, Hanne

doi:10.1016/j.sapharm.2014.03.003

Cited by 41 publications

(54 citation statements)

References 25 publications

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“…Across categories of concordance, an average of 47 % of patients experienced improvement in concordance, reflecting a positive development in their ability to take an active part in decision making about their health and treatment. This improvement in concordance is higher than in a similar study conducted with patients with type 2 diabetes, where only 21 % of patients improved their self-reported concordance [25]. This may reflect a lower baseline concordance in the ethnic minority target group compared to patients with type 2 diabetes.…”

Section: Self-assessed Outcomescontrasting

confidence: 72%

“…The counseling program has previously shown significant improvements in outcomes for patients with hypertension and type 2-diabetes [17,24,25].…”

Section: Discussionmentioning

confidence: 99%

“…The model was validated for patients with hypertension and type 2-diabetes, based on the framework for complex interventions published by the British Medical Research Council (MRC) [23]. Hence, the model and the individual elements were evaluated and tested in more explorative and learning-oriented studies focusing on process and feasibility [24,25].…”

Section: The Intervention -Safe and Effective Use Of Medicines For Etmentioning

confidence: 99%

“…Self-reported adherence behavior was detected by a validated questionnaire [25], differentiating between intentional and unintentional non-adherence (Table 2). It consisted of three subscales related to behavior-related non-adherence: "unintentional", "intentional self-regulation", "intentional", and "effect-related".…”

Section: Data Collection and Analysismentioning

confidence: 99%

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Safe and Effective Use of Medicines for Ethnic Minorities - A Pharmacist- Delivered Counseling Program That Improves Adherence

Herborg¹

2015

J Pharma Care Health Sys

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Background: From studies, we know how ethnic minorities and people with reduced work ability often suffer from health problems, thus being socially disadvantaged. The municipal job centers are confronted with numerous problems related to medicine use and they lack relevant means of referral. Thus, there was a need to adapt a previously developed and validated medicine-based intervention "safe and effective use of medicines" to this vulnerable group of unemployed ethnic minority patients. Methods:The objective of this before-after study was to improve medicines adherence, health status and work ability of the target group through an individualized pharmacist delivered intervention with focus on safe and effective implementation of medical treatments. The target group was ethnic minorities of non-western origin affiliated with a job center.Results: At baseline, 35.7 % of the patients had a potential adherence behavior problem Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation (having an average adherence score of less than 5); at endpoint, this number had decreased to 27.3 %, meaning that 8.4 % no longer had potential adherence problems. Self-reported adherence was significantly improved on three out of four subscales ("Intentional, selfregulation" from 4.5 to 4.7, p=0.016); "Unintentional" from 3.9 to 4.2, p=0.009); "Intentional, effect-related" from 4.0 to 4.4, p=0.025; "General" 4.3 to 4.5, p=0.173.). On average, 47 % of the patients experienced improvements in concordance, due to the intervention. Conclusion:The counseling program "Safe and effective use of medicines" was successfully adapted to unemployed ethnic minority patients, and tested in a new collaboration between job centers and community pharmacies. The counseling program resulted in statistically significant improvements in self-reported adherence as well as improved concordance for approximately half of the patients. Improvements in adherence removes one barrier for returning to the work force that exists in the complex interaction between adherence, health status and work ability. Citation: Dam P, El-Souri M, Herborg H, Nørgaard LS, Rossing C, et al. (2015) Safe and Effective Use of Medicines for Ethnic Minorities -A

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Section: Self-assessed Outcomescontrasting

confidence: 72%

“…The counseling program has previously shown significant improvements in outcomes for patients with hypertension and type 2-diabetes [17,24,25].…”

Section: Discussionmentioning

confidence: 99%

Section: The Intervention -Safe and Effective Use Of Medicines For Etmentioning

confidence: 99%

Section: Data Collection and Analysismentioning

confidence: 99%

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Safe and Effective Use of Medicines for Ethnic Minorities - A Pharmacist- Delivered Counseling Program That Improves Adherence

Herborg¹

2015

J Pharma Care Health Sys

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“…[19] A comprehensive and a brief individually targeted intervention for patients with Type 2 diabetes by pharmacist could improve implementation of drug therapy. [20] Moreover, pharmacist involvement in multidisciplinary healthcare team may promote quality improvement in safe medication management [21] and reduce medical cost. [22] The pharmacist may also use a checklist tool to assist them to identify issues in therapy and management of their Type 2 diabetes patients systematically and enable earlier intervention to improve metabolic control.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Adnyana

2017

IJGP

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Introduction: Type 2 diabetic patients whom also diagnosed with hypertension often received a complex medication regimen. The situation may lead to the increased risk of drug-related problems (DRPs). The aim of the study was to identify the DRPs in Type 2 diabetic patients whom also diagnosed with hypertension in the following domains: Problems, causes, and interventions. Subjects and Methods: The prospective study was conducted from October to December 2015 at a secondary care hospital in Indonesia involving 90 inpatients who meet the predetermined inclusion criteria. Identification and classification of DRPs were based on the Pharmaceutical Care Network Europe version 5.01. Correlation among patient's independent factors and the number of DRPs was also analyzed using bivariate analysis. Results: As many as 261 DRPs were identified, averaging 2.88 (standard deviation = 0.23) problems per patient. Drug choice problem was the most frequent problems (n = 144, 55.17%) while drug/dose selection was the main causes (n = 184, 62.16%). From a total 155 interventions, the majority was conducted at patient/carer level (n = 94, 60.65%). The bivariate analysis showed that the number of medications (r = 0.49, P < 0.01) and the length of stay (r = 0.25, P < 0.05) significantly correlated with the number of DRPs. Based on linear regression analysis, the number of medications significantly predicted the number of DRPs (β = 0.50, P < 0.001). Conclusion: Since the risk of DRPs in Type 2 diabetic and hypertension patients is relatively high, early detection by the pharmacist is needed to ensure the safety and effectiveness of drug therapy.

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Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

Yogasingam

Konnyu

Lépine

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a large body of evidence evaluating quality improvement (QI) programmes to improve care for adults living with diabetes. These programmes are often comprised of multiple QI strategies, which may be implemented in various combinations. Decision‐makers planning to implement or evaluate a new QI programme, or both, need reliable evidence on the relative effectiveness of different QI strategies (individually and in combination) for different patient populations. Objectives To update existing systematic reviews of diabetes QI programmes and apply novel meta‐analytical techniques to estimate the effectiveness of QI strategies (individually and in combination) on diabetes quality of care. Search methods We searched databases (CENTRAL, MEDLINE, Embase and CINAHL) and trials registers (ClinicalTrials.gov and WHO ICTRP) to 4 June 2019. We conducted a top‐up search to 23 September 2021; we screened these search results and 42 studies meeting our eligibility criteria are available in the awaiting classification section. Selection criteria We included randomised trials that assessed a QI programme to improve care in outpatient settings for people living with diabetes. QI programmes needed to evaluate at least one system‐ or provider‐targeted QI strategy alone or in combination with a patient‐targeted strategy. ‐ System‐targeted: case management (CM); team changes (TC); electronic patient registry (EPR); facilitated relay of clinical information (FR); continuous quality improvement (CQI). ‐ Provider‐targeted: audit and feedback (AF); clinician education (CE); clinician reminders (CR); financial incentives (FI). ‐ Patient‐targeted: patient education (PE); promotion of self‐management (PSM); patient reminders (PR). Patient‐targeted QI strategies needed to occur with a minimum of one provider or system‐targeted strategy. Data collection and analysis We dual‐screened search results and abstracted data on study design, study population and QI strategies. We assessed the impact of the programmes on 13 measures of diabetes care, including: glycaemic control (e.g. mean glycated haemoglobin (HbA1c)); cardiovascular risk factor management (e.g. mean systolic blood pressure (SBP), low‐density lipoprotein cholesterol (LDL‐C), proportion of people living with diabetes that quit smoking or receiving cardiovascular medications); and screening/prevention of microvascular complications (e.g. proportion of patients receiving retinopathy or foot screening); and harms (e.g. proportion of patients experiencing adverse hypoglycaemia or hyperglycaemia). We modelled the association of each QI strategy with outcomes using a series of hierarchical multivariable meta‐regression models in a Bayesian framework. The previous version of this review identified that different strategies were more or less effective depending on baseline levels of outco...

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Safe and effective use of medicines for patients with type 2 diabetes – A randomized controlled trial of two interventions delivered by local pharmacies

Cited by 41 publications

References 25 publications

Safe and Effective Use of Medicines for Ethnic Minorities - A Pharmacist- Delivered Counseling Program That Improves Adherence

Safe and Effective Use of Medicines for Ethnic Minorities - A Pharmacist- Delivered Counseling Program That Improves Adherence

Untitled

Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

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