Abstract

Impact of pharmaceutical care activities on diabetic patients at a private corporate hospital

Author(s):Sriram S, Suresh Damodharan, Akhila S. Arjun, Latha MA and Nandipati Raghuram

Diabetes is a disease that desperately needs more pharmacist involvement. Pharmaceutical care and expanded role of pharmacist are associated with many positive diabetes related outcomes, including improved clinical measures, improved patient and provider satisfaction, and improved cost management. Studies have shown that type 2 diabetes is associated with impaired QoL as diabetes increases morbidity and decreases life expectancy. It is known that diabetes and stress are directly or indirectly related, and it is important to evaluate stress in patients with diabetes. To evaluate the impact of pharmaceutical care in patients with type 2 Diabetes mellitus and to provide education and information regarding the disease and life style modification. A prospective comparative study on impact of pharmaceutical care on type 2 diabetes mellitus patients was conducted in a private tertiary care teaching hospital in South India for a period of 6 months. Study was done on 120 eligible patients with type 2 diabetes mellitus enrolled randomly in the intervention group (with pharmaceutical care teachings) or the control (without drug related educations). The intervention group patients received pharmaceutical care through diabetes education, medication counseling, instructions on lifestyle that needed modifications (necessary for better drug function) and dietary regulations regarding their prescribed drugs, whereas the control group patients were deprived of any pharmaceutical care till the end of the study. Data were analyzed using SPSS software to find out the t-student test. The problem areas in diabetes (PAID) questionnaire is a reliable and valid tool which is used in our study to determine diabetes specific emotional distress among our study group. A minimum score of 0 indicated no diabetesrelated distress. A maximum score of 100 indicated significant diabetes-related distress. The intervention group showed an improvement in the quality of life score from -2.156 ± 0.12 at the baseline to -1.41 ± 0.13 at the final interview (p < 0.01). The average HbA1c values decreased from 8.63 ± 2.27 % to 7.24 ± 1.39 % (p < 0.05). There was a significant decrease in the fasting blood glucose from 203.05 ± 89.05 mg/dl to 115.55 ± 39.03 mg/dl between the baseline and the final interview in the intervention group (p < 0.05).The average BMI values also decreased from 25.06 ± 3.6 % to 24.21 ± 3.3% (p<0.05). The PAID scores before the interview had a value of 49.78 ± 22.34 and after the interview with a lower score of 31.39 ± 17.12 showed significant improvement from the baseline scores (p =0.00). The PAID scores were significantly higher in patients newly diagnosed with diabetes followed by 1-5yrs and female patients. Glycated hemoglobin was directly related to the score, but the group with very high glycated hemoglobin (over 10%) had lower PAID ratings. The study concluded that pharmacist mediated patient counseling of the disease, medications and lifestyle modifications will improve the Quality of life and Glycemic control. The assessment of quality of life in patients with diabetes could help to improve patient’s wellbeing. Greater attention to treating illness by addressing its psychological side through support and coping strategies, and not just the disease, has important implications for reducing health disparities among disadvantaged groups.

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