Effect of Pharmacist’s Interventions on Glycemic Control in Diabetic Patients: A Systematic Review and Meta-analysis of Randomized Controlled TrialsNalinee Poolsup, Naeti Suksomboon,* Methinee Intarates
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Several clinical trials have evaluated the effect of pharmacists’ interventions. However, the results have been inconsistent. We performed a systematic review to evaluate the effect of pharmacists’ interventions on glycemic control in diabetes. Clinical trials of pharmacists’ interventions aimed at improving glycemic control in diabetes patients were identified through a systematic search of MEDLINE, CINAHL, Web of Science, the Cochrane Library, and THAILIS. The bibliographic databases were searched from their inceptions to the end of February 2012. The references lists of relevant articles were checked and experts were consulted. Studies were included if they were: i) randomized controlled trials of pharmacists’ interventions aimed at improving glycemic control in diabetes patients, ii) reporting HbA1c as an outcome measure, iii) published in English or Thai, and iv) clearly describing details of pharmacists’ intervention. Treatment effect was estimated with the mean difference in the change of HbA1c levels from baseline between the intervention and the control groups. Twenty-two trials involving 2,808 patients were included. Pharmacists’ interventions included an assessment and adjustment of anti-diabetic medications, identification of drug-related problems, co-operation with physicians and other members of the health care team, offering diabetes booklets and special medication containers, providing education concerning self-management of diabetes, and reinforcement of diabetes management with pharmacotherapy and non-pharmacotherapy. This meta-analysis showed that pharmacists’ interventions can improve glycemic control in diabetes patients (mean difference -0.68%, 95% CI -0.87% to -0.49%, p < 0.00001). Thus, pharmacists can play an important role in diabetes management.
Keyword:
systematic review, pharmaceutical care, glycemic control, diabetes
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