Outcomes of Pharmacist-led Diabetes Care Intervention in Lao PDR: a randomized controlled trial
Main Article Content
Keywords
pharmacists , pharmaceutical care, Patient Satisfaction, Quality of life, Diabetes type 2
Abstract
Objective: Pharmaceutical care for diabetic patients has demonstrated benefits in many countries. Nevertheless, in Laos, diabetes care has been provided without pharmacists’ involvement. This study aimed to evaluate the outcomes of pharmacist-led interventions in diabetes care in Laos. Methods: A single-blinded randomized controlled trial with pre-test and post-test was designed. The study was undertaken in type 2 diabetes patients registered at a hospital from June 2019 to July 2020. Patients in the intervention group received pharmaceutical care in six months, while the control group received standard care. Primary outcomes were hemoglobin A1c (HbA1c) and fasting plasma glucose. Secondary outcomes included blood pressure, lipid profiles, renal function, 10-year risk, patient satisfaction, and quality of life. Intention-to-treat analysis was applied. Results: One hundred forty-four diabetes patients were recruited and randomly assigned to groups (73 intervention, 71 control); 121 were included in the analysis (64 intervention, 57 control). Of the 67 pharmacist interventions, adding statin/aspirin (doctor acceptance rate of 79.10%) was predominant. After six months, achievement of hemoglobin A1c and LDL goals showed improvement (OR 1.31, 95%CI .50- 3.43, p.589; OR 1.35, 95%CI .61-3.01, p=.465), however, no statistically significant differences in clinical outcomes were found between groups. Compared to the pretest, the intervention group showed significant improvements in HbA1c, cholesterol, and low-density lipoprotein levels (p<.05). Nevertheless, the control group also showed significant improvement in HbA1c (p<.05). Patient satisfaction with pharmacists’ competency was statistically significantly higher in the intervention group than the control group (p=.010). Conclusion: Pharmacist-led diabetes care could provide clinical benefits and improve patient satisfaction due to pharmacists’ competency. Although pharmacists' intervention did not yield statistically better clinical outcomes than usual care, there was a trend toward better HbA1c and cholesterol controls. Continuous pharmacists’ contributions to diabetes care, including advancing the collaborative protocol, should be further supported.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Phoutsathaphone Sibounheuang, PhD program, Faculty of Pharmacy, Mahasarakham University, Kharmrieng Sub-District, Kantarawichai District, Mahasarakham, 44150, Thailand
Faculty of Pharmacy, University of Health Sciences, Samsenthai Road, Kao ngot Villagem, Sisattanak District, Vientiane Capital, Lao PDR