Impact of Community Pharmacy Diabetes Care Program on Knowledge and Glycemic Control: An Unexplored Opportunity for Community Pharmacists in Pakistan

Abstract

Madeeha Malik, Usman Aslam, Azhar Hussain and Ayisha Hashmi

Background: Effective management of diabetes mellitus depends on efficacy of therapy as well as patient adherence to medication therapy and non-pharmacological approaches. One of the most important tools to improve patient adherence is counseling. Community pharmacists can effectively contribute to patient care as they have the expertise and accessibility to do the task appropriately.

Objective: The objective of the study was to evaluate the impact of pharmacist counseling on glucose control and medication adherence of diabetic patients attending community pharmacies in Pakistan.

Method: A randomized, controlled, single blinded, pre-post intervention study design was used. The respondents included patients diagnosed with both diabetes mellitus (Type I or II) visiting community pharmacies for purchasing their regular medicine. Simple random sampling technique by lottery method was used to select community pharmacies to be included in-group A (intervention n=4) and group B (control n=4). The total number of patients were 40 in each group while estimating a drop-out rate of 25%. Convenience sampling technique was used to select patients visiting community pharmacies. Patients in the intervention group received special counseling. Blood glucose was checked after every 15 days for a period of six months. Pre-validated tools such as diabetes knowledge questionnaire 24 and brief medication questionnaire were used. Data was cleaned, coded and analyzed in SPSS 21. Wilcoxon test (p≥0.05) was used to compare pre-post intervention knowledge regarding diabetes and. Mann-Whitney test (p≥0.05) was used to find differences among medication adherence among control and intervention groups as well as pre and post intervention.

Results: The results of the present study showed that respondents having diabetes since the past 1-3 years had comparatively better knowledge scores (18.8, 3±2.04) after intervention. Mean knowledge scores regarding diabetes mellitus among intervention group at baseline was (16.02, ±2.93) which was improved after six months (19.97, ±2.66). Significant difference was observed (p≤0.05) in pre-post intervention knowledge regarding diabetes management. Knowledge of patients was improved regarding different aspects of diabetes management after counseling by community pharmacists. The fasting blood glucose improved at three months (9.32, ±1.92) and after six months (8.95, ±1.45) in intervention group.

Conclusion: The results of the current study concluded that counseling by community pharmacist has a positive impact on blood glucose management among diabetic and patients. Educational programs should be initiated by community pharmacists as this can lead to improvement in glycemic control and enhance the image of pharmacist as a key health care member in management of chronic diseases.

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