Impact of clinical pharmacist intervention on diabetes related quality-of-life in an ambulatory care clinic
The purpose of this one-year observational study was to evaluate quality of life in patients at the Medical University of South Carolina Family Medicine clinic who were followed by a clinical pharmacist diabetes educator.
Methods: Patients who have been seen by the clinical pharmacist for diabetes education and management services were contacted by telephone and asked to complete a previously validated Diabetes-related Quality of Life (DRQL) survey. In addition, the patient’s most recent hemoglobin A1C, blood pressure, fasting lipid panel and aspirin use were obtained from the electronic medical record. Correlation and logistic regression analysis was completed in order to assess the quality of life score and clinical outcomes.
Results: A total of 47 patients completed the survey (37%). The median overall score was 1 (1-very satisfied; 5-very dissatisfied). Patients who were more satisfied with their current treatment tended to have lower LDL, systolic and diastolic blood pressure (BP) values (r=0.32, 0.3, 0.33; p=0.03, 0.03, 0.02). In addition, patients taking more medications were more dissatisfied with the amount of time spent managing their disease (r=0.29, p=0.04), felt more pain associated with the treatment of their disease (r=0.32, p=0.02), and were more worried that their body looked different as a result of their diabetes (r=0.32, p=0.02).
Conclusion: Patients in this clinic were highly satisfied with their quality of life. The authors found that trends exist for relationships between several important clinical parameters and quality of life.
2. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Eng J Med 1993;329:977-86.
3. UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulfonyureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.
4. Keil PJ, McCord AD. Pharmacist impact on clinical outcomes in a diabetes disease management program via collaborative practice. Ann Pharmacother 2005;39:1828-32.
5. Morello CM, Zadvorny EB, Cording MA, Suemoto RT, Skog J, Harari A. Development and clinical outcomes of pharmacist-managed diabetes care clinics. Am J Health-Syst Pharm 2006;63:1325-31.
6. Scott DM, Boyd ST, Stephan M, Augustine SC, Reardon TP. Outcomes of pharmacist-managed diabetes care services in a community health center. Am J Health-Syst Pharm 2006;63:2116-22.
7. Ragucci KR, Fermo JD, Wessell AM, Chumney CG. Effectiveness of Pharmacist-Administered Diabetes Mellitis Education and Management Services. Pharmacotherapy 2005;25:1809-1816.
8. Cranor CW, Bunting BA, Christensen DB. The Ashville Project: Long-term Clinical and Economic Outcomes of a Community Pharmacy Diabetes Care Program. J Am Pharm Assoc 2003; 43:173.
9. Lial S, Glover JJ, Herrier RN, Felix A. Improving quality of care in diabetes through a comprehensive pharmacist-based disease management program. Diabetes Care 2004;27(12):2983-84.
10. The DCCT Research Group. Influence of intensive diabetes treatment on Quality-of-Life outcomes in the Diabetes Control and Complications Trial. Diabetes 1996;19:195-202.
11. Centers for Disease Control and Prevention. Self-rated fair or poor health among adults with diabetes--United States, 1996-2005. MMWR Morb Mortal Wkly Rep 2006;55(45):1224-7.
12. Baran RW, Crumlish K, Patterson H, Shaw J, Erwin WG, Wylie JD, Duong P. Improving outcomes of community-dwelling older patients with diabetes through pharmacist counseling. Am J Health-Syst Pharm 1999;56:1535-9.
13. Jaber LA, Halapy H, Fernet M, Tummalapalli S, Diwakaran H. Evaluation of a pharmaceutical care model on diabetes management. Ann Pharmacother 1996;30:238-43.
14. Cranor CW, Christensen DB. The Ashville Project: Short-term outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc 2003;43:149-59.
15. Standards of Medical Care in Diabetes. Diabetes Care 2007 30: S4-41.
16. The DCCT Research Group. Reliability and validity of a diabetes Quality-of-Life measure for the Diabetes Control and Complications Trial (DCCT). Diabetes Care 1988; 11:725-31.
17. Luscombe FA. Health-related quality of life measurement in type 2 diabetes. Value Health 2000;3(supp1):S15-28.
The authors hereby transfer, assign, or otherwise convey to Pharmacy Practice: (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print pr epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to Pharmacy Practice with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Author Self-Archiving Policy
Pharmacy Practice permits and encourages authors to post and archive the final pdf of the articles submitted to the journal on personal websites or institutional repositories after publication, while providing bibliographic details that credit its publication in this journal.