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Theivasigamani K, Palaniappan S. An Overview of Pharmaceutical Care in Type II Diabetes Mellitus Patients: Current Position and Prospects. Curr Diabetes Rev 2024; 20:e050523216588. [PMID: 37151063 DOI: 10.2174/1573399819666230505123428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/17/2023] [Accepted: 02/02/2023] [Indexed: 05/09/2023]
Abstract
Diabetes mellitus is an ongoing disease that is related to a high mortality rate due to severe complications. Diabetes mellitus type 2 (DMT2) is a persistent metabolic deficiency and its prevalence has been increasing consistently worldwide. As a result, it is rapidly turning into a plague in some parts of the world, and the number of people affected is expected to double in the following decade due to an increase in the maturing populace, adding to the overall existing importance for medical service providers, particularly in the underdeveloped nations. Extensive diabetes care is an intricate task that takes a whole group of medical care experts, including drug specialists, to provide multidisciplinary care for the patients. The duty of drug experts has changed significantly in recent years, changing from conventional drug dispensing in the drug store to patient- centered clinical support services. Upgrading the medication treatment to accomplish better remedial results without causing drug-related issues has been considered the essential objective of treatment for diabetic patients. This review discusses the healthcare needs of patients with T2DM, the current evidence for the role of pharmacists in diabetes care, and insight into the upcoming role of pharmacists in its management. The advanced role of clinical pharmacists in diabetes control through drug treatment, diabetes care centers, and diabetes health counselor schooling, is also discussed in this review.
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Affiliation(s)
- Kumutha Theivasigamani
- Research Scholar, Karpagam Academy of Higher Education, Coimbatore, India
- Nandha College of Pharmacy, Erode, India
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Al Assaf S, Kleiner D, Zelkó R, Hankó B. Type 2 Diabetes Patients' Views of Local Pharmacists and Fulfilment with Pharmaceutical Diabetes Care in Syria's Latakia Governorate: An Online Survey Research. Healthcare (Basel) 2023; 11:1720. [PMID: 37372838 DOI: 10.3390/healthcare11121720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Assessing the attitudes of diabetic patients towards community-pharmacy services and determining the demand for new services could help monitor and evaluate the therapeutic response. This study aimed to evaluate type 2 diabetes patients' satisfaction regarding pharmacy care in community pharmacies and shed a light on the reasons for diabetic patients' non-adherence to treatments. An online survey was conducted on a random sample of patients (n = 196) at the national Diabetes Centre in Latakia, Syria, from April to November 2022. The questionnaire consisted of four primary parts: (1) demographic characteristics of responders, (2) patients' therapeutic behaviors, (3) diabetes knowledge, and (4) the general level of satisfaction with pharmacy diabetes services. The data were analyzed using descriptive analysis. Around 89% of respondents were satisfied with the information provided by community pharmacists. The patients' non-adherence showed a maximum as a function of the number of concomitantly taken medicines, which indicated that in most serious cases patients' adherence was increasing. Overall, most patients were delighted with community pharmacists' expertise and pharmacy services. This positive image allows pharmacists to expand their duties as healthcare providers in diabetes care, and increase the patient therapeutic adherence by performing a reconciliation of the patient's medicines, which involves reviewing all patients' drugs and identifying realistic solutions to their adherence issues.
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Affiliation(s)
- Sarah Al Assaf
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
| | - Dénes Kleiner
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
| | - Romána Zelkó
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
| | - Balázs Hankó
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
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Jackson IL, Isah A, Arikpo AO. Willingness to Pay for Clinical Pharmacy Services Among People With Diabetes in Nigerian Community Pharmacies. Value Health Reg Issues 2023; 35:95-101. [PMID: 36933549 DOI: 10.1016/j.vhri.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/30/2022] [Accepted: 01/25/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES This study aimed to assess willingness to pay (WTP) for clinical pharmacy services among people with diabetes and to determine the factors affecting WTP for these services. METHODS This was a cross-sectional exit survey of 450 people with diabetes visiting 15 community pharmacies in Uyo metropolis, Akwa Ibom State, Nigeria, between August and September 2021. Self-reported questionnaires were administered to eligible patients just before leaving the community pharmacy. Data were analyzed using SPSS (version 25.0). Statistical significance was set at P < .05. RESULTS Response rate was 87.3%. Two hundred respondents (50.9%) were willing to pay an average amount of US$2.83 (minimum-maximum, US$0.12-US$24.27) for clinical pharmacy services. The two most often cited reasons for those who were unwilling to pay were their inability to pay and their opposition to paying for any healthcare services. Employment status (P < .001), personal monthly income (P < .001), satisfaction with income (P < .001), household monthly income (P < .001), health insurance coverage (P < .001), insulin use (P < .001), perception of the pharmacist's relevance in healthcare (P = .013) and in diabetes care (P < .001), and satisfaction with the pharmacist's services (P < .001) significantly affected WTP choices. None of the patient characteristics predicted the maximum amounts patients were willing to pay. CONCLUSIONS Many of the people with diabetes assessed were willing to pay for clinical services at a reasonable price. Although most patient variables affected their WTP choices, none of the variables predicted the maximum amount they were willing to pay. For possible remuneration for clinical services, community pharmacists should continue to grow their practices and stay current with patient care.
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Affiliation(s)
- Idongesit L Jackson
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Akwa Ibom State, Nigeria.
| | - Abdulmuminu Isah
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Abam O Arikpo
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Akwa Ibom State, Nigeria
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Hoxha I, Apuk V, Kryeziu B, Rashiti P, Aliu M, Aquines AG, Khan O, Nguyen HTH. Management of Non-Communicable Diseases in Kosovo: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3299. [PMID: 36833997 PMCID: PMC9961581 DOI: 10.3390/ijerph20043299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Background-Non-communicable diseases (NCDs) affect a growing share of the population in Kosovo. The country faces challenges with NCDs management, specifically detecting, screening, and treating people with NCDs. Objective-To assess the management of NCDs, including the inputs that influence the provision of NCDs and outcomes of NCD management. Eligibility criteria-Studies had to report NCD management in Kosovo. Sources of evidence-We systematically searched Google Scholar, PubMed, Scopus, and Web of Science. Charting methods-The data were charted by two researchers. We extracted data on general study details and design and information on the management and outcomes of NCDs in Kosovo. Synthesis of results-For the mix of studies that were included in the review, thematic narrative synthesis was used. We developed a conceptual framework based on health production core components to analyze the data. Results-Kosovo's health care system is available to provide basic care for patients with NCDs. However, there are serious limitations in the availability of key inputs providing care, i.e., funding, medicines, supplies, and medical staff. Additionally, in terms of the management of NCDs, there are areas for improvement, such as limited application of clinical pathways and guidelines and issues with referrals of patients among levels and sectors of care. Finally, it is worth noting that there is overall limited information on NCD management and outcomes. Conclusions-Kosovo provides only basic services and treatment of NCDs. The data reporting the existing situation on NCD management are limited. The inputs from this review are helpful for existing policy efforts by the government aimed to enhance NCD care in Kosovo. Funding-This study is part of the research done for a World Bank review of the state of NCDs in Kosovo and was funded through the Access Accelerated Trust Fund (P170638).
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Affiliation(s)
- Ilir Hoxha
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH 03766, USA
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
- Research Unit, Heimerer College, 10000 Prishtina, Kosovo
| | - Valid Apuk
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
- Swiss Tropical Public Health Institute, 4000 Basel, Switzerland
| | - Besfort Kryeziu
- National Institute of Public Health of Kosovo, 10000 Prishtina, Kosovo
| | - Premtim Rashiti
- Emergency Clinic, University Clinical Center of Kosovo, 10000 Prishtina, Kosovo
| | | | | | - Olga Khan
- The World Bank, 1020 Vienna, Austria
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Waszyk-Nowaczyk M, Guzenda W, Kamasa K, Zielińska-Tomczak Ł, Cerbin-Koczorowska M, Michalak M, Przymuszała P, Plewka B. Polish Patients' Needs and Opinions about the Implementation of Pharmaceutical Care in Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:945. [PMID: 36673701 PMCID: PMC9859607 DOI: 10.3390/ijerph20020945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
The study aimed to get to know patients' opinions on implementing pharmaceutical care for diabetic patients in a community pharmacy to prevent and effectively and holistically approach the treatment of people with diabetes. It was based on an authorial survey form and conducted from August to October 2021 in a community pharmacy in Poznan, Poland. A total of 131 pharmacy patients over 18 years were included in the study. Results showed that the vast majority of patients confirmed their interest in pharmaceutical care in diabetes conducted by pharmacists. Moreover, 79.4% of respondents would like to benefit from medicines use review, while 87.0% confirmed an interest in the 'New Drug' service, with diabetic patients being particularly interested in this (p = 0.2447). Most respondents were also interested in education on how to use a glucose meter, administer insulin and use a lancing device. In addition, the study showed patients' insufficient knowledge about risk factors and prevention of diabetes with the need for patient education. As the source of funding, 91.7% of diabetic patients indicated the National Health Fund. Given that such a service has not been implemented in Poland yet, this study may support established teams at the Supreme Pharmaceutical Chamber or the Ministry of Health in introducing such new services.
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Affiliation(s)
- Magdalena Waszyk-Nowaczyk
- Pharmacy Practice Division, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
| | - Weronika Guzenda
- Pharmacy Practice Division, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
| | - Karolina Kamasa
- Student’s Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
| | - Łucja Zielińska-Tomczak
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka Street., 60-806 Poznan, Poland
| | - Magdalena Cerbin-Koczorowska
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka Street., 60-806 Poznan, Poland
| | - Michał Michalak
- Chair and Department of Computer Science and Statistics, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60-806 Poznan, Poland
| | - Piotr Przymuszała
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka Street., 60-806 Poznan, Poland
| | - Beata Plewka
- Pharmacy Practice Division, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
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Axon DR, Alamer A, Almatruk Z, Fazel MT. Assessing student pharmacists' confidence and knowledge of basic diabetes self-management skills. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:982-989. [PMID: 36055707 DOI: 10.1016/j.cptl.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 06/02/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The significance of diabetes self-management and recent advances in diabetes medications call for healthcare professionals' preparedness in educating patients. This study assessed correlations between student pharmacists' confidence and knowledge of diabetes self-management skills. METHODS An online questionnaire was administered to third-year student pharmacists at one United States college of pharmacy. Students indicated their level of agreement (strongly disagree, disagree, agree, strongly agree) with nine confidence items and identified the correct multiple-choice response for nine knowledge items. Correlations between confidence and knowledge scores were assessed using simple linear regression, logistic regression, and Spearman rank (Rho) test. RESULTS Forty-five students completed the questionnaire. The majority agreed/strongly agreed that they were confident in their knowledge for eight of the nine confidence items. The majority correctly answered six of the nine knowledge items. No associations were identified between confidence and knowledge scores in the linear regression (beta scaled = 0.25) or Spearman's correlation test (r = 0.294). In the logistic regression model, confidence and knowledge scores were associated positively for three domains: glucose meter use (odds ratio [OR] = 4.88), glucagon-like peptide-1 receptor agonist use (OR = 4.23) and hyperglycemia treatment (OR = 3.33); confidence and knowledge scores were associated negatively with one domain: insulin syringe administration (OR = 0.41). CONCLUSIONS This study found no overall association between confidence and knowledge scores in third-year student pharmacists' basic diabetes self-management skills, although there were significant associations with four specific domains. Student pharmacists may require additional training to improve their diabetes self-management skills.
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Affiliation(s)
- David R Axon
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
| | - Ahmad Alamer
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States; Prince Sattam bin Abdulaziz University College of Pharmacy, Al-Kharj, Riyadh, Post Box 173, 11942, Saudi Arabia.
| | - Ziyad Almatruk
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States; King Abdelaziz University College of Pharmacy, Jeddah, Makkah 22252, Saudi Arabia.
| | - Maryam T Fazel
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
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Alabkal RM, Medlinskiene K, Silcock J, Graham A. Impact of Pharmacist-Led Interventions to Improve Clinical Outcomes for Adults With Type 2 Diabetes at Risk of Developing Cardiovascular Disease: A Systematic Review and Meta-analysis. J Pharm Pract 2022:8971900211064459. [PMID: 35579209 DOI: 10.1177/08971900211064459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis of randomised controlled trials is to evaluate the impact of pharmacist-led interventions on cardiovascular disease (CVD) risk factors among patients with type 2 diabetes. METHOD A literature review was conducted according to PRISMA guidelines using 4 electronic databases: Embase, MEDLINE, CINHAL and the Cochrane Central Register of Controlled Trials. We searched for pharmacist interventions among adults with type 2 diabetes and cardiovascular disease in randomised controlled trials from inception to May 2021 in primary care, diabetes clinics and hospitals. The clinical outcomes measured glycosylated haemoglobin (HbA1c), blood pressure (BP) and lipid profile. The non-clinical outcomes included medication adherence, smoking, health-related quality of life and the cost of the intervention. For the meta-analysis, clinical outcomes were pooled with the random effect model in RevMan 5.3. The Cochrane risk-of-bias tool was used to assess the quality of the included studies. RESULTS We retrieved 223 studies,141 of which were included in the review. Ten published articles met the inclusion criteria and were included in the meta-analysis. The pharmacists delivered the interventions alone or collaboratively with other healthcare professionals in hospitals or similar settings. The overall result showed a significant reduction in HbA1c (n = 10; standard deviation in mean value [SDM]: -.53%, 95% CI: -.84, -.23) and systolic BP (n = 10; [SDM]: -.35 mmHg, 95% CI: -.51, -.20) in pharmacist intervention groups. For the non-clinical outcomes, the review revealed variable results from pharmacist intervention compared with those standard care. CONCLUSION Pharmacy interventions provide evidence for pharmacists' decisive role in diabetes care management and reducing cardiovascular risk factors among adults with type 2 diabetes.
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Affiliation(s)
- Rahma M Alabkal
- School of Pharmacy, Faculty of Life Sciences, 1905University of Bradford, Bradford, UK
| | - Kristina Medlinskiene
- Pharmacy Doctoral Training Fellow, Faculty of Life Sciences, 1905University of Bradford, Bradford, UK
| | - Jonathan Silcock
- Senior Lecturer in Pharmacy Practice, Faculty of Life Sciences, 1905University of Bradford, Bradford, UK
| | - Anne Graham
- Associate Dean (Research & Knowledge Transfer), Faculty of Life Sciences, 1905University of Bradford, Bradford, UK
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AlSubaie N, Alsallal M, AlTwaijri S, AlOtaibi A, AlHarbi B, AlEissa M, Alrashedi R. Impact of Clinical Pharmacist Diabetes Clinic on the Improvement of Health Outcomes in Type 2 Diabetes Subjects. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This study aimed to evaluate the improvement of HbA1c, lipid profile, blood pressure readings, and weight in type 2 diabetes at the clinical pharmacist diabetes clinic (CPDC) in ambulatory care clinic.
METHODS: A retrospective study was conducted at a CPDC; the clinical pharmacist role was to follow-up the referred uncontrolled type 2 diabetes patients and providing comprehensive management.
RESULTS: A total of 419 patients were included the study. The mean ± standard error of the mean (SEM) age was 58.9 ± 0.59 years old. Sixty-two percent of the patients were female. At baseline, mean HbA1C ± SEM was 10.69% ± 0.06%, mean low-density lipoprotein (LDL) ± SEM was 2.66 ± 0.04 mmol/l. After 3 months of follow-up, HgbA1C had a statistically significant improvement by a reduction of 1.69% to be 9% ± 0.09% (95% confidence interval [CI] [1.50–1.87], p < 0.001). Moreover, mean HbA1C had a statistically significant improvement after 6 months of follow-up compared to baseline by 1.78% to be 8.9% ± 0.21% (95% CI [1.33–2.22], p < 0.001). LDL had a statistically significant improvement after 3 months by 0.24 mmol/l to be 2.42 ± 0.04 mmol/l (95% CI [0.15–0.35], p < 0.001) and after 6 months of follow-up by 0.28 mmol/l to be 2.38 ± 0.04 mmol/l (95% CI [0.20–0.36], p < 0.001).
CONCLUSION: The results stated that the clinical pharmacist anticipated care is achievable and had significant effect in the reduction of HbA1C and LDL levels in patients with uncontrolled type 2 diabetes.
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Presley B, Groot W, Pavlova M. Pharmacists' preferences for the provision of services to improve medication adherence among patients with diabetes in Indonesia: Results of a discrete choice experiment. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e161-e174. [PMID: 34009714 PMCID: PMC9292582 DOI: 10.1111/hsc.13423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/22/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
Little is known about pharmacists' preferences for services to improve medication adherence in patients with diabetes in Indonesia. Identification of such preferences can provide valuable insights on suitable services from a pharmacist's perspective. This study elicits pharmacists' preferences for services to improve medication adherence among their patients. A discrete choice experiment (DCE) method was used to survey pharmacists in all community health centres and three hospitals in Surabaya, Indonesia. Four attributes of consultation, namely duration of consultation, place of consultation, access to a pharmacist and patient copayment, and two attributes on additional services (educational and behavioural-based services) were included. The 16 profiles generated for DCE were partially balanced and partially without overlap. A random-effect logistic regression was used in the analysis. In total, 99 pharmacists completed the questionnaire, but only 80 were included in the study based on a consistency check. All attributes were found to determine preferences for a pharmacist service package. Pharmacists preferred a consultation with a shorter duration accompanied by flexible access to the pharmacist as well as a private consultation room and a lower patient copayment. Providing the patient with a brochure/leaflet was the most preferred additional service to help improve medication adherence. Patient group discussion and medication review were also preferred in combination with a consultation. Pharmacists' socio-demographic background characteristics influence preferences. These findings can be considered in evaluating current practice and designing pharmacist services to help improve medication adherence among patients with diabetes.
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Affiliation(s)
- Bobby Presley
- Department of Health Services Research (HSR)Faculty of Health, Medicine and Life Sciences (FHML)Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+)Maastricht UniversityMaastrichtThe Netherlands
- Department of Clinical and Community PharmacyFaculty of PharmacyCenter for Medicines Information and Pharmaceutical Care (CMIPC)University of SurabayaSurabayaIndonesia
| | - Wim Groot
- Department of Health Services Research (HSR)Faculty of Health, Medicine and Life Sciences (FHML)Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+)Maastricht UniversityMaastrichtThe Netherlands
| | - Milena Pavlova
- Department of Health Services Research (HSR)Faculty of Health, Medicine and Life Sciences (FHML)Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+)Maastricht UniversityMaastrichtThe Netherlands
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Franch-Nadal J, Fornos JA, Melogno Klinkas M, Rodríguez de Miguel M, Rodríguez-Fortúnez P, Lizán L, de Paz HD, Lería Gelabert M. Management of prediabetes from the perspective of Spanish physicians and community pharmacists: Detecta2 study. ENDOCRINOL DIAB NUTR 2021; 68:708-715. [PMID: 34924159 DOI: 10.1016/j.endien.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/22/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Prediabetes is a high-risk state for diabetes. The study aims to describe routine clinical practice and the views of physicians and pharmacists on prediabetes management. MATERIALS AND METHODS An observational, descriptive, cross-sectional study was conducted using a structured questionnaire. RESULTS A total of 410 physicians and 393 pharmacists completed the questionnaire. Self-adherence to clinical practice guidelines (CPGs) was reported by 51.5% and 23.2% of physicians and pharmacists, respectively. Less than 60% of participants defined prediabetes according to main CPG. Regarding the use of screening strategies to detect prediabetes (physicians: 96%; pharmacists: 42.1%), reports indicate the opportunistic strategy is widely employed (≥75%) whereas systematic screening is unusual (<20%). Changes in lifestyle were deemed essential by almost all participants (≥95%), but in clinical practice only 58.3% of healthcare centers and 28.0% of pharmacies were found to provide awareness-raising/instruction. The role of pharmacists in the prevention of prediabetes/diabetes was judged useful by most participants. CONCLUSIONS Use of CPG, systematic prediabetes screening strategies, and specific strategies for patient education are scarce. The support of community pharmacists in prediabetes management was well valued. Therefore, it is crucial that the lines of action followed by both physicians and pharmacists align with each other and with the CPG.
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Affiliation(s)
- Josep Franch-Nadal
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain; CAP Drassanes Raval-Sud, Barcelona, Spain
| | | | | | | | | | - Luis Lizán
- Outcomes'10, S.L., Castellón de la Plana, Spain; Medicine Department, Jaume I University, Castellón de la Plana, Spain
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McGrath N, McHugh S, Racine E, Kearney PM, Lynch B, Toomey E. Barriers and enablers to screening and diagnosing diabetes distress and depression in people with type 2 diabetes mellitus: A qualitative evidence synthesis. Prim Care Diabetes 2021; 15:923-936. [PMID: 34446371 DOI: 10.1016/j.pcd.2021.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 11/19/2022]
Abstract
AIM Synthesise qualitative evidence of healthcare professionals' (HCP) experiences of diabetes distress and depression screening in people with type 2 diabetes (T2DM) in primary care to identify HCP barriers and enablers to screening implementation. METHODS Searched six electronic databases in October 2020 for qualitative studies exploring HCPs' experiences of diabetes distress and depression screening in T2DM populations. Applying a best-fit framework synthesis, data were coded to the theoretical domains framework (TDF), followed by thematic analysis of data that did not fit the TDF. Study quality and confidence in findings were assessed using CASP and GRADE-CERQual respectively. FINDINGS Of 4942 unique records identified, 10 articles were included. We identified fifteen barriers and enablers in 8 TDF domains and 1 new domain; people with T2DM factors. One barrier (poor awareness about the rationale for screening) and 2 enablers (perceived impacts on T2DM care, receiving financial reimbursement) were assessed as findings of high confidence. CONCLUSION HCPs experience many barriers and enablers to diabetes distress and depression screening among people with T2DM in primary care. Future interventions and policies should ensure HCPs understand the rationale for screening, highlight the benefits of screening, resource screening appropriately and address HCP group specific barriers.
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Affiliation(s)
- Niamh McGrath
- School of Public Health, University College Cork, Ireland.
| | - Sheena McHugh
- School of Public Health, University College Cork, Ireland
| | - Emmy Racine
- School of Public Health, University College Cork, Ireland
| | | | - Brenda Lynch
- Centre for Policy Studies, University College Cork, Ireland
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Ireland
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Presley B, Groot W, Pavlova M. Pharmacists' and patients' perceptions about the importance of pharmacist services types to improve medication adherence among patients with diabetes in Indonesia. BMC Health Serv Res 2021; 21:1227. [PMID: 34774041 PMCID: PMC8590236 DOI: 10.1186/s12913-021-07242-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Various pharmacist services are available to improve medication adherence, including consultation, brochure, etc. Challenges arise on which services are best implemented in practice. Knowledge about patients' and pharmacists' preferences can help to prioritize services. This study explores the pharmacists' and patients' perceptions about the importance of pharmacist services to improve medication adherence among patients with diabetes in Indonesia. METHODS This questionnaire-based cross-sectional study involved adult outpatients with diabetes type 2 and pharmacists from community health centers (CHCs) and hospitals in Surabaya, Indonesia. Random sampling was used to identify 57 CHCs in the study. In addition, based on convenient sampling, three hospitals participated. All pharmacists working at the CHCs and hospitals, who were willing to participate, were included in the study. For patients, minimum sample size was calculated using Slovin's formula. Patients and pharmacists were asked to rank five pharmacist service types (consultation, brochure/leaflet, patient group discussion, medication review, and phone call refill reminder) according to their importance to improve medication adherence. A face validity test of the self-developed questionnaire was conducted before the data collection. Rank ordered probit models were estimated (STATA 15th software). RESULTS A total of 457 patients from CHCs, 579 patients from hospitals, and 99 pharmacists from both medical facilities were included. Consultation (CHC patients 56.0% vs hospital patients 39.7% vs pharmacists 75.2%) and brochure (CHC patients 23.2% vs hospital patients 27.5% vs pharmacists 11.9%) were the most preferred pharmacist services. Patients with experience getting medication information from pharmacists valued consultation higher than brochure and patient group discussions. Older patients ranked a brochure higher than other services. Patients without formal education in CHCs had a lower probability of giving a high rank to a brochure to improve medication adherence. There was significant positive correlation between the ranking of phone call refill reminder and medication review (0.6940) for patients in CHCs. CONCLUSION For both patients and pharmacists, consultation, brochure, and group discussion were the highest-ranked services. Education, age, experience with pharmacist services, and medical facility features need to be considered when evaluating which pharmacist services to implement in Indonesia.
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Affiliation(s)
- Bobby Presley
- Department of Health Services Research (HSR), Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, PO Box 616, Maastricht, MD, 6200, The Netherlands.
- Department of Clinical and Community Pharmacy, Center for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, University of Surabaya, Surabaya, East Java, 60293, Indonesia.
| | - Wim Groot
- Department of Health Services Research (HSR), Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, PO Box 616, Maastricht, MD, 6200, The Netherlands
| | - Milena Pavlova
- Department of Health Services Research (HSR), Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, PO Box 616, Maastricht, MD, 6200, The Netherlands
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Abdulrhim S, Awaisu A, Ibrahim MIM, Diab MI, Hussain MAM, Al Raey H, Ismail MT, Sankaralingam S. Impact of pharmacist-involved collaborative care on diabetes management in a primary healthcare setting using real-world data. Int J Clin Pharm 2021; 44:153-162. [PMID: 34637104 DOI: 10.1007/s11096-021-01327-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
Background Diabetes mellitus is a complex multi-system disorder, requiring multi-disciplinary care. The conventional care model, where physicians are the sole caregivers may not be optimal. Addition of other healthcare team members improves healthcare outcomes for patients with diabetes. Aim To evaluate the impact of pharmacist-involved collaborative care on diabetes-related outcomes among patients with diabetes attending a primary healthcare setting in Qatar using real-world data. Method A retrospective cohort study was conducted among patients with diabetes attending Qatar Petroleum Diabetes Clinic. Patients were categorized as either receiving pharmacist-involved collaborative care (intervention group) or usual care (control group). Data were analyzed using SPSS®. Glycemic control (glycated hemoglobin A1c, HbA1c), blood pressure, lipid profile, and body mass index were evaluated at baseline and up to 17 months of follow-up. Results After 17 months of follow-up, pharmacist-involved collaborative care compared to usual care resulted in a significant decrease in HbA1c (6.8 ± 1.2% vs. 7.1 ± 1.3%, p < 0.01). Moreover, compared to baseline, pharmacist-involved collaborative care significantly improved (p < 0.05) the levels of HbA1c (7.5% vs. 6.8%), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), and body mass index (30.42 kg/m2 vs. 30.17 kg/m2) after 17 months within the intervention group. However, no significant changes for these parameters occurred within the control group. Conclusion The implementation of pharmacist-involved collaborative care in a primary healthcare setting improved several diabetes-related outcomes over 17 months. Future studies should determine the long-term impact of this care model.
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Affiliation(s)
- Sara Abdulrhim
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Mohammad Issam Diab
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Hend Al Raey
- Qatar Petroleum Diabetes Clinic, Qatar Petroleum Healthcare Center, Dukhan, Qatar
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Simon MA, Raja BY, Varughese PC, Daniel LM, Sowjanya K, S KJ, S S, Rathinam KK, Kumar J P. Pharmacist led intervention towards management of type 2 diabetes mellitus and assessment of patient satisfaction of care - A prospective, randomized controlled study. Diabetes Metab Syndr 2021; 15:102208. [PMID: 34298274 DOI: 10.1016/j.dsx.2021.102208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Diabetes mellitus, a metabolic disorder characterized by hyperglycaemia is due to impaired insulin secretion and deficiency. Though effective current drug therapies are available for diabetes, yet glycaemic maintenance remains a challenge without medication adherence. This necessitates a holistic approach to improve clinical outcomes for a better patient health care. METHODS A prospective, interventional, randomized controlled study was conducted among 97 type 2 diabetic patients for 6 months. The primary outcome measures included patient satisfaction of care assessment by diabetes treatment satisfaction questionnaire (DTSQ) and medication adherence by medication adherence rating scale (MARS). Secondary outcomes included assessment of knowledge, attitude, and perception and laboratory parameters. The collected data was analyzed using paired and unpaired T-test. RESULTS Of 97 patients randomized to group A (n = 49) and group B (n = 48), there were 3 and 1 drop-out in group A and B, respectively. The mean age of patients was found to be 56.82 ± 4.06 years. At the 6thmonth follow up, significant improvement of glycaemic parameters was observed in group A vs B. Mean MARS and DTSQ scores also improved in group A vs. B (P-value <0.05). CONCLUSION Pharmacist-provided counselling improves patient compliance, quality of life and satisfaction of care in diabetic patients.
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Affiliation(s)
- Manithottiyle Angelo Simon
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India
| | - Bandaru Yeswanth Raja
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India
| | - Paulin C Varughese
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India
| | - Linda Mary Daniel
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India
| | - Kolli Sowjanya
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India
| | - Kumar J S
- Department of General Medicine, SRM Medical College Hospital and Research Centre, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603203, Chengalpattu (DT), Tamil Nadu, India
| | - Sarumathy S
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India.
| | - Kiran Kumar Rathinam
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India
| | - Pravin Kumar J
- Department of Pharmacy Practice, SRM College of Pharmacy, Faculty of Medical & Health Sciences, SRM Institute of Science and Technology, Kattankulathur, 603 203, Chengalpattu (DT), Tamil Nadu, India
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15
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Franch-Nadal J, Fornos JA, Melogno Klinkas M, Rodríguez de Miguel M, Rodríguez-Fortúnez P, Lizán L, de Paz HD, Lería Gelabert M. Management of prediabetes from the perspective of Spanish physicians and community pharmacists: Detecta2 study. ENDOCRINOL DIAB NUTR 2021; 68:S2530-0164(21)00103-8. [PMID: 34016564 DOI: 10.1016/j.endinu.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Prediabetes is a high-risk state for diabetes. The study aims to describe routine clinical practice and the views of physicians and pharmacists on prediabetes management. MATERIALS AND METHODS An observational, descriptive, cross-sectional study was conducted using a structured questionnaire. RESULTS A total of 410 physicians and 393 pharmacists completed the questionnaire. Self-adherence to clinical practice guidelines (CPGs) was reported by 51.5% and 23.2% of physicians and pharmacists, respectively. Less than 60% of participants defined prediabetes according to main CPG. Regarding the use of screening strategies to detect prediabetes (physicians: 96%; pharmacists: 42.1%), reports indicate the opportunistic strategy is widely employed (≥75%) whereas systematic screening is unusual (<20%). Changes in lifestyle were deemed essential by almost all participants (≥95%), but in clinical practice only 58.3% of healthcare centers and 28.0% of pharmacies were found to provide awareness-raising/instruction. The role of pharmacists in the prevention of prediabetes/diabetes was judged useful by most participants. CONCLUSIONS Use of CPG, systematic prediabetes screening strategies, and specific strategies for patient education are scarce. The support of community pharmacists in prediabetes management was well valued. Therefore, it is crucial that the lines of action followed by both physicians and pharmacists align with each other and with the CPG.
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Affiliation(s)
- Josep Franch-Nadal
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain; CAP Drassanes Raval-Sud, Barcelona, Spain
| | | | | | | | | | - Luis Lizán
- Outcomes'10, S.L., Castellón de la Plana, Spain; Medicine Department, Jaume I University, Castellón de la Plana, Spain
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16
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Ngo TKC, Vo TH, Le C. Knowledge, attitude, and practice concerning hypoglycaemia, insulin use, and insulin pens in Vietnamese diabetic outpatients: Prevalence and impact on safety and disease control. J Eval Clin Pract 2021; 27:404-413. [PMID: 32779295 DOI: 10.1111/jep.13454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 12/23/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES This study aimed to assess the knowledge, attitude, and practice (KAP) of Vietnamese diabetics in an outpatient setting regarding hypoglycaemia, insulin use, and insulin pen and to evaluate the factors related to the KAP, adverse drug reactions (ADRs), and glycaemic control status. METHODS We interviewed patients by 16-item questions on knowledge and eight questions on attitude, and requested the patient to demonstrate the injection technique with a sampled insulin pen. RESULTS The response rate was 74% (148 patients included). The proportions of patient having a good knowledge, positive attitude, and good practice were 45.9%, 78.4%, and 44.6%, respectively. The two most common incorrect steps in using insulin pen were skipping to prime pen needle (90.9%) and not removing the used needle from the pen after using (87.8%). Patients using insulin at least 1 year had better knowledge (P = .025), more positive attitude (P = .017), and better practice of using insulin pen (P = .042). Patients had more positive attitude of insulin's role (P = .038) if they either used insulin in combination with oral diabetic medications or had history of using insulin vials. The number of patients having good knowledge was statistically significant higher in participants who previously received counselling from health professionals (P = .001). We also found a positive correlation between good knowledge of patients and good practice skills (P < .001). Patients with poor practice of insulin were more likely to have ADRs at the injection sites (P = .013). The patients with poorer level of knowledge had significant higher risk of hypoglycaemia (P = .001). KAP levels did not correlate with glycaemic control status. CONCLUSIONS The majority of outpatients had positive attitude towards insulin's role; however, their knowledge and practice of hypoglycaemia and using insulin pen needs improvement. This study will be helpful in the planning of patient education strategies.
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Affiliation(s)
- Thi Kim Cuc Ngo
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thi Ha Vo
- Faculty of Pharmacy, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam.,Department of Pharmacy, Nguyen Tri Phuong Hospital, Ho Chi Minh, Vietnam
| | - Chuyen Le
- Pharmacology Department, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
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17
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Kane MP, Triplitt CL, Solis-Herrera CD. Management of type 2 diabetes with oral semaglutide: Practical guidance for pharmacists. Am J Health Syst Pharm 2021; 78:556-567. [PMID: 33354706 PMCID: PMC7970404 DOI: 10.1093/ajhp/zxaa413] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To provide pharmacists with information on counseling patients with type 2 diabetes (T2D) receiving oral semaglutide. SUMMARY Oral semaglutide, the first oral glucagon-like peptide 1 (GLP-1) receptor agonist (GLP-1RA), was approved for the treatment of adults with T2D by the US Food and Drug Administration in September 2019. Semaglutide has been coformulated with the absorption enhancer sodium N-(8-[2-hydroxybenzoyl] amino) caprylate to improve bioavailability of semaglutide following oral administration. Oral semaglutide has been shown to have efficacy and safety profiles similar to those of other GLP-1RAs. Many patients with T2D have a complex oral medication regimen to manage their T2D and concomitant chronic comorbid conditions. Therefore, it is important that patients follow the dose administration instructions closely: oral semaglutide should be taken on an empty stomach upon waking with a sip (≤120 mL) of plain water and at least 30 minutes before the first food, beverage, or other oral medications of the day. The most common adverse effects of oral semaglutide are gastrointestinal (typically nausea, diarrhea, and vomiting). It is important for pharmacists to counsel patients prescribed oral semaglutide about optimal oral dosing, why correct dosing conditions are necessary, expected therapeutic response, and effective strategies to mitigate potential gastrointestinal adverse events. CONCLUSION Information and practical strategies provided by pharmacists may facilitate initiation and maintenance of oral semaglutide therapy and ensure that each patient achieves an optimal therapeutic response.
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Affiliation(s)
- Michael P Kane
- Albany College of Pharmacy and Health Sciences, Albany, NY, USA
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18
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Ahmed F, Hammad SA, Lin JF, Gennaro TL, Gaspard AL, Sarpong DF, Onor IO. A1C Reduction in Patients Who Declined Pharmacist-Led Diabetes Management Services. J Pharm Pract 2021; 35:413-421. [PMID: 33567944 DOI: 10.1177/0897190021993390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The purpose of this research is to assess the mean change in A1C associated with patients who declined a pharmacy-led diabetes management program and to evaluate effects of predictor variables on the odds of achieving improved A1C in these patients. STUDY DESIGN Retrospective, single-center, single-group, cohort study. METHODS Patients 18 years or older with uncontrolled type 2 diabetes (defined as A1C ≥ 9%) who declined pharmacy-led diabetes management services were included in the study. The primary outcome of the study was to assess the mean change in A1C from time of phone call offering pharmacy management services (initial) to last observed A1C (final recorded A1C). RESULTS A total of 91 patients were included, 46 males and 45 females. The significant reduction in the mean change from baseline A1C to the final measured A1C was -0.59 (95% CI, -0.9327% to -0.2447%, P-value = 0.0010). This resulted in 8.79% of patients' final A1C falling into the range of < 7%. CONCLUSION Our study found a paradoxical reduction in A1C among patients who declined pharmacy-led diabetes management services, however, our study is limited by having no comparison group. Further research needs to be conducted to identify correlations between characteristics of patients declining diabetes management services in order to assist with identifying patient-specific methods for improving patient outcomes.
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Affiliation(s)
- Fahamina Ahmed
- Division of Clinical and Administrative Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA.,East Jefferson General Hospital-Family Medicine Clinic, Metairie, LA, USA
| | - Samah A Hammad
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Jonathan F Lin
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Teresa L Gennaro
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Alexis L Gaspard
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
| | - Daniel F Sarpong
- Center for Minority Health & Health Disparities Research & Education, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA
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Sah SK, R S, Ramesh M, Chand S. Impact of pharmacist care in the management of autoimmune disorders: A systematic review of randomized control trials and non-randomized studies. Res Social Adm Pharm 2021; 17:1532-1545. [PMID: 33423904 DOI: 10.1016/j.sapharm.2020.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/12/2020] [Accepted: 12/13/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Autoimmune disorders are chronic, self-mediated, misdirected immune responses against their own immune system. It required intensive, complex and costly drug treatment regimen increased the risk of pharmacotherapy error and adversely affects patients. Hence, pharmacist care will have vital roles in autoimmune disorders to achieve health related outcomes. OBJECTIVES This review aimed to gather evidence on the impact of pharmacist care on clinical, humanistic and economic outcomes, adherence to medications, and drug related problems in the management of autoimmune disorders among the usual care group. METHODOLOGY A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMed Central, Web of Sciences, Scopus, Cochrane Library andgoogle scholar from inception until August 2020. This research included full-text articles of randomized and non-randomized studies that evaluated impact of pharmacist care in autoimmune disorders. RESULTS A total of nine studies were included (seven RCTs and two non-RCTs), including 829 patients with autoimmune disorders. A total of four studies (80%) show an enhancement in at least one clinical parameter due to pharmacist care. A substantial improvement in at least one humanistic parameter observed in all five studies (100%). While four out of five studies (80%) clearly displayed a remarkable improvement in medication adherence in the pharmacist care group from baseline to the completion of follow-ups. One study quantified a 99.08% resolution of DRPs in the pharmacist care group. Another study estimated the cost of medical resources uses per patient and found no difference in cost-effectiveness over six months between groups. CONCLUSION This review reinforces the vital contribution of pharmacists to achieve clinical outcomes, humanistic outcomes, adherence to medications and DRPs in the efficient management of autoimmune disorders. However, no notable changes in economic outcomes were observed in this review.
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Affiliation(s)
- Sujit Kumar Sah
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, Karnataka, India.
| | - Subramanian R
- Department of Rheumatology & Immunology, JSS Medical College & Hospital, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, Karnataka, India.
| | - Madhan Ramesh
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, Karnataka, India.
| | - Sharad Chand
- Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to Be University), Paneer, Deralakatte, Mangaluru, 575018, Karnataka, India.
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Chu LT, Nguyen TQ, Pham PTT, Thai TT. The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam. J Diabetes Res 2021; 2021:9921376. [PMID: 34497858 PMCID: PMC8419491 DOI: 10.1155/2021/9921376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) who have limited knowledge about hypoglycemia and insulin pen use are likely to have hypoglycemia and other complications. OBJECTIVE This study aimed to evaluate the effectiveness of health education on knowledge about hypoglycemia and insulin pen use among outpatients with T2DM at a primary care hospital in Vietnam. METHODS A pretest-posttest study was conducted among 80 patients with T2DM at District 11 Hospital in Ho Chi Minh City, Vietnam. At baseline, patients were interviewed through a predefined, structural questionnaire to assess their knowledge about hypoglycemia and insulin pen use. After that, patients underwent an individual health education session about hypoglycemia and insulin pen. One month and two months after this intervention, knowledge about hypoglycemia and insulin pen use were recorded again. RESULTS The majority were males (65.0%) and the mean age was 59.6 (standard deviation 8.1, range 35-75) years. Very few patients had good knowledge and proper insulin pen use, with percentages ranging from 13.8% to 60%. There was a significant improvement of knowledge and practice after the intervention. Such improvement remained high one month and two months after the intervention. CONCLUSIONS The health education intervention is effective in improving knowledge and practice in this population. There is a pressing need for such intervention at primary care hospitals to optimize treatment for patients with T2DM, possibly focusing on those who had characteristics to have the best effectiveness found in this study.
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Affiliation(s)
- Loan Thi Chu
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, District 5, Ho Chi Minh City, Vietnam
| | - Tran Que Nguyen
- Department of Nursing, University Medical Center Ho Chi Minh City, 215 Hong Bang, District 5, Ho Chi Minh City, Vietnam
| | - Phuong Thu Thi Pham
- Hospital for Rehabilitation-Occupational Diseases at Ho Chi Minh City, 313 Au Duong Lan Street, District 8, Ho Chi Minh City, Vietnam
| | - Truc Thanh Thai
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, District 5, Ho Chi Minh City, Vietnam
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Gillani SW, Kaka Khan KK, Ladouani D, Salama NA. A Systematic Review on Pharmaceutical Diabetic Care Services in the United Arab Emirates (UAE). Curr Diabetes Rev 2021; 17:e122820189559. [PMID: 33371838 DOI: 10.2174/1573399817999201228210029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/25/2020] [Accepted: 11/02/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE the aim of this systematic review study is to evaluate the current services and pharmaceutical care practices for diabetic patients in the UAE. METHODS systematic review coverage conforms to the guidelines of the PRISMA; the search was limited to primary research articles, which describe the term "pharmaceutical diabetes care services in UAE". The search strategy was developed in collaboration with a health database librarian, and a predetermined protocol was developed in conjunction with the authors for search methods. RESULTS The findings showed the effect of a prescription treatment system on disease prevention and health-related quality of life in patients with type 2 diabetes in the United Arab Emirates. A retrospective interventional health evaluation was implemented to evaluate existing health procedures and the impact of conventional treatment on type 2 diabetes treatment (T2DM). The findings of this interventional evaluation were largely favorable, and the viability of changing the existing clinical procedure was stressed. The individualized strategy has helped clinicians finding a great result in terms of glycemic and BP, as well as patient satisfaction. The need for more work to clarify the long-term effect of organized strategy in enhancing the consistency of T2DM treatment in the UAE. The findings also showed increase community pharmacy services might further change the opinions of patients on the level of care provided by such pharmacies. The patients' quality of life would improve by drug treatment efficacy and pharmacist services to mitigate diabetes complications. The findings showed a prescription treatment system on disease prevention and health-related quality of life in patients with type 2 diabetes in the United Arab Emirates. A retrospective interventional health evaluation was implemented to evaluate existing health procedures and the impact of conventional treatment on type 2 diabetes treatment (T2DM). The findings of this interventional evaluation were largely favorable, and the viability of changing the existing clinical procedure was stressed. The individualized strategy has helped clinicians reach a great result in terms of glycemic and BP, as well as patient satisfaction. The need for more work to clarify the long-term effect of organized strategy in enhancing the consistency of T2DM treatment in the UAE. The findings also showed increase community pharmacy services mightfurther change the opinions of patients on the level of care provided by such pharmacies. The patients' quality of life would improve by drug treatment efficacy and pharmacist services to mitigate diabetes complications. CONCLUSION This systematic review reported beneficial pharmacist-led diabetic management services in the UAE. Several care strategies were also highlighted to improve service for type 2 diabetes mellitus patients.
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Affiliation(s)
- Syed Wasif Gillani
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Khanda Kareem Kaka Khan
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Douaa Ladouani
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Nour Alaa Salama
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
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Khan AH, Iqbal MZ, Syed Sulaiman SA, Ibrahim A, Azmi NSBY, Iqbal MS, Albassam AA. Impact of Pharmacist-led Educational Intervention on Predictors of Diabetic Foot at Two Different Hospitals of Malaysia. J Pharm Bioallied Sci 2020; 13:108-115. [PMID: 34084056 PMCID: PMC8142923 DOI: 10.4103/jpbs.jpbs_475_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 11/18/2022] Open
Abstract
Objective: Diabetes mellitus (DM) is a chronic metabolic disorder that can initiate organ damage inside the body if not treated appropriately. Apart from tight glycemic control, a suitable educational intervention is also needed from health-care providers to stop or decrease the progression of organ damage in diabetic patients. This study intended to measure the impact of pharmacist-led educational intervention on improvement in predictors of diabetic foot in two different hospitals in Malaysia. Materials and Methods: In two tertiary care selected hospitals, the included diabetic patients were randomly divided into two study arms. In the control group, 200 patients who were receiving usual treatment from hospitals were included. However, in the intervention group, those 200 patients who were receiving usual treatment along with counseling sessions from pharmacists under the Diabetes Medication Therapy Adherence Clinic (DMTAC) program were included. The study continued for 1 year, and there were four follow-up visits for both study arms. A prevalidated data collection form was used to measure the improvement in predictors of diabetic foot in included patients. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 24.0. Results: With the average decrease of 1.97% of HbA1c values in the control group and 3.43% in the intervention group, the univariate and multivariate analysis showed a statistically significant difference between both of the study arms in the improvement of predictors belonging to the diabetic foot (P < 0.05). The proportion of patients without any signs and symptoms of the diabetic foot in the intervention group was 91.7%, which increased from 42.3% at baseline (P < 0.05). However, this proportion in the control group was 76.9% at the fourth follow-up, from 48.3% at baseline (P < 0.05). Conclusion: A statistically significant reduction in the signs and symptoms of diabetic foot was observed in the intervention group at the end of 1 year. The progression of diabetic foot was significantly decreased in the pharmacist intervention group.
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Affiliation(s)
- Amer Hayat Khan
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Muhammad Zahid Iqbal
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.,Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, AIMST University Malaysia, Penang, Malaysia
| | - Syed Azhar Syed Sulaiman
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.,Advanced Medical and Dental Institute, Sains at Bertam, Universiti Sains Malaysia, Penang, Malaysia
| | - Aznita Ibrahim
- Physician for Endocrinology, Ministry of Health Malaysia, Hospital Sultan Abdul Halim, Sungai Petani, Kedah Malaysia
| | | | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
| | - Ahmed A Albassam
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
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Abdulrhim S, Sankaralingam S, Ibrahim MIM, Awaisu A. The impact of pharmacist care on diabetes outcomes in primary care settings: An umbrella review of published systematic reviews. Prim Care Diabetes 2020; 14:393-400. [PMID: 31926868 DOI: 10.1016/j.pcd.2019.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/22/2019] [Accepted: 12/25/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To systematically review published systematic reviews (SRs) examining the impact of pharmacist interventions in multidisciplinary diabetes care teams on diabetes-related clinical, humanistic, and economic outcomes in primary care settings. METHODS PubMed, EMBASE, Scopus, Database of Abstracts of Reviews of Effects, Cochrane Library, Joanna Briggs Institute (JBI) Database, Google Scholar, and PROSPERO were searched from inception to 2018. Studies published in English evaluating the effect of pharmacist interventions on diabetes outcomes were included. Two independent reviewers were involved in screening of titles and abstracts, selection of studies, and methodological quality assessment. RESULTS Seven SRs were included in the study. Three of them included only randomized controlled trials, while the rest involved other study designs. Educational interventions by clinical pharmacists within the healthcare team were the most common types of interventions reported across all SRs. Pharmacist's interventions compared to usual care resulted in favorable significant improvements in hemoglobin A1c (HbA1c), fasting blood glucose, blood pressure, body mass index, total cholesterol, low density lipoprotein, high density lipoprotein and triglycerides in more than 50% of the SRs. Improvement in HbA1c was the mostly reported clinical outcome of pharmacist intervention in the literature (reported in six SRs). Pharmacist's interventions led to significant cost-saving ($8-$85,000 per person per year), cost-utility, and cost-benefit (benefit-to-cost ratio range from 1:1 to 8.5:1) versus usual care. Pharmacist's interventions improved patients' quality of life (QoL) in three SRs; however, no conclusion can be drawn due to the use of diverse QoL assessment tools. CONCLUSIONS Most SRs support the benefit of pharmacist care on diabetes-related clinical, humanistic, and economic outcomes in primary care settings. Improvements in diabetes outcomes can significantly reduce the burden of diabetes on healthcare system. Hence, the incorporation of pharmacists into multidisciplinary diabetes care teams is beneficial and should be strongly considered by clinicians and health policymakers.
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Affiliation(s)
- Sara Abdulrhim
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | | | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
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Khdour M, Awadallah HB, Al-Hamed DH. Assessment of treatment satisfaction and adherence amongst diabetic patients in governmental primary care clinic of Ramallah, West-Bank. Hosp Pract (1995) 2020; 49:27-33. [PMID: 32901519 DOI: 10.1080/21548331.2020.1822083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to assess treatment satisfaction and its association with medication adherence among patients with diabetes. METHODS Participants in this study were outpatients at the governmental Primary Healthcare Unit in Ramallah. Adherence was measured with the 4-item Morisky Green-Levine (MGL) questionnaire, and treatment satisfaction with the Treatment Satisfaction Questionnaire for Medication version 1.4. Glycemic control was measured as the last value of an HbA1c test, with HbA1c ≤7 considered good. RESULTS Of the participants, 220 (57.9%) were classified as having high adherence to their medications, and 160 (42.1%) as having low adherence. Regarding glycemic control, 174 (45.7%) of patients had good control, while 206 (54.2%) had poor control. Satisfaction with treatment effectiveness showed a significant mean difference with adherence level (78.61 vs. 74.2; p = 0.04). Glycemic controlled patients had a higher and significant adherence mean in the global satisfaction domain (69.19 vs. 62.08; p = 0.01). However, glycemic control level had no significant differences in means of effectiveness, side effects, and convenience domains (P = 0.31, 0.49, 0.37) respectively. CONCLUSIONS Treatment satisfaction level is lower among low adherence and poor glycemic control. Addressing the specific needs of these patients might be effective in improving their satisfaction, thus having a positive influence on other clinical outcomes.
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Affiliation(s)
- Maher Khdour
- Department of Pharmacy, Al Quds University , Jerusalem, Israel
| | | | - Dua'a H Al-Hamed
- Department of Pharmacy, Ramallah and Al-bireh health directorate , West Bank, Palestine
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Rathbun RC, Durham SH, Farmer KC, Zuckerman AD, Badowski ME. Evaluation of human immunodeficiency virus curricular content in schools of pharmacy in the United States. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:910-917. [PMID: 32564992 DOI: 10.1016/j.cptl.2020.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 02/05/2020] [Accepted: 04/04/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Human immunodeficiency virus (HIV) is an important educational topic for student pharmacists given extended patient life expectancy and expanding pharmacist roles in HIV treatment and prevention. Data are lacking in regard to curricular content and type of training received by faculty to provide didactic and experiential HIV training. METHODS A cross-sectional, population-based survey of United States (US) pharmacy schools was conducted using a 15-item questionnaire. HIV content experts were surveyed at 135 four-year, accredited programs. RESULTS Thirty-seven responses were received from schools in the Midwestern (34%), Northeastern (26%), Southern (26%), and Western (14%) regions. Time devoted to didactic HIV education ranged from 0.5 to 60 hours. The majority of respondents (78%, n = 29) reported 10 or fewer hours of HIV-related content, with 41% (n = 15) reporting five or less hours of content. Experiential practice sites for HIV training were variable, with a majority (80%) including an outpatient infectious diseases/HIV clinic. Eighty percent of respondents also reported students receiving fewer than 25 encounters with people living with HIV (PLWH) throughout their entire experiential training. Over half (54%) of respondents reported that the primary HIV instructor devoted four hours per week or less to HIV care. CONCLUSIONS Diversity in the amount of time devoted to HIV didactic education existed among reporting US pharmacy schools. Few schools have dedicated faculty spending a substantial amount of time in direct care of PLWH. Minimum standards for HIV education in schools of pharmacy should be established.
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Affiliation(s)
- R Chris Rathbun
- Clinical and Administrative Sciences, University of Oklahoma Health Sciences Center College of Pharmacy, 1110 N. Stonewall Ave., Oklahoma City, OK 73117, United States.
| | - Spencer H Durham
- Auburn University Harrison School of Pharmacy, 1202a Walker Building, Auburn, AL 36849, United States.
| | - Kevin C Farmer
- Clinical and Administrative Sciences, University of Oklahoma Health Sciences Center College of Pharmacy, 1110 N. Stonewall Ave., Oklahoma City, OK 73117, United States.
| | - Autumn D Zuckerman
- Specialty Pharmacy, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, United States.
| | - Melissa E Badowski
- University of Illinois at Chicago College of Pharmacy, 833 S. Wood Street, MC 886, Room 164, Chicago, IL 60607, United States.
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Aluh DO, Anyachebelu OC, Ajaraonye CI. Comparison of pharmacists' mental health literacy: Developed versus developing countries. J Am Pharm Assoc (2003) 2020; 60:S64-S72. [PMID: 32580909 DOI: 10.1016/j.japh.2020.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 04/22/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the mental health literacy (MHL) of pharmacists in Nigeria and their comfort rendering pharmacy services to patients with mental illness with that of pharmacists in developed countries. DESIGN A cross-sectional study design was employed. Questionnaires containing closed, ordinal, Likert-type, and multi-choice questions were used to elicit information from the respondents. SETTING AND PARTICIPANTS Pharmacists from all areas of practice attending the 91st Annual Conference of the Pharmaceutical Society of Nigeria from October 29 to November 3, 2018, were conveniently sampled. OUTCOME MEASURES Pharmacists' MHL, stigma, desired social distance, and comfort rendering pharmacy services were compared with relevant literature from developed countries. RESULTS Of the approximately 360 pharmacists who received the survey, 117 responded (32.5%). Although less than half (45.3%, n = 48) of the pharmacists reported that antidepressants were beneficial in treating depressive symptoms, almost all of them (96.2%, n = 102) rated antipsychotics to be helpful for schizophrenia. The desired social distance was higher in schizophrenia than in depression (P = 0.001). More than half (57.1%, n = 61) of the pharmacists surveyed believed that violence was more likely among persons with a mental illness. The respondents reported a higher level of comfort giving medication advice to patients with cardiovascular disease than to those with mental illness (P < 0.001). Approximately one-third (34.0%, n = 36) of the pharmacists agreed that they had sufficient training in the identification and management of mental illness. Literature from developed countries showed high levels of MHL among pharmacists in terms of knowledge but relatively high levels of stigma, desired social distance, and discomfort rendering pharmaceutical care to patients with mental illness. CONCLUSION The findings indicate some knowledge gaps and misconceptions among Nigerian pharmacists regarding mental illness. The stigma and desired social distance among pharmacists in this study were comparable to findings from developed countries.
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Al-Taie A, Izzettin FV, Sancar M, Köseoğlu A. Impact of clinical pharmacy recommendations and patient counselling program among patients with diabetes and cancer in outpatient oncology setting. Eur J Cancer Care (Engl) 2020; 29:e13261. [PMID: 32537812 DOI: 10.1111/ecc.13261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 12/10/2019] [Accepted: 04/16/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The simultaneous occurrence of diabetes and cancer may complicate the management of both conditions resulting in poor prognosis and more deterioration of patient-related outcomes. OBJECTIVE To assess the effective provision of clinical pharmacy services and pharmacist-led counselling program on improving patient-related outcomes among patients with diabetes and newly diagnosed with cancer during chemotherapy administration. METHODS A single-centre, prospective, randomised, controlled study was carried out on patients with diabetes newly diagnosed with cancer during chemotherapy administration at the outpatient oncology setting. Patients were assigned as a normal care group receiving only normal care by the oncology care providers and an intervention group receiving both normal and clinical pharmacy care through an extensive oral and written patient education, pharmacotherapy optimisation and regular recommendations for diabetic self-care activities with three-month follow-up. RESULTS Patients within the intervention group showed a better glycaemic control (p = .049), a significant increase in medication adherence (p = .0049), a significant increase in diabetes self-care activities, including diet (p = .037), self-monitoring of blood glucose (p = .027) and foot care (p = .0085) and reported a lower deterioration in quality of life. CONCLUSION Patients with diabetes and cancer receiving chemotherapy experienced improved patient-related outcomes after clinical pharmacy intervention and counselling program compared to the normal care group.
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Affiliation(s)
- Anmar Al-Taie
- Faculty of Pharmacy, Pharmacy Department, Girne American University, Kyrenia, North Cyprus, Turkey
| | - Fikret V Izzettin
- Faculty of Pharmacy, Clinical Pharmacy Department, Bezmialem Vakıf University, Istanbul, Turkey
| | - Mesut Sancar
- Faculty of Pharmacy, Clinical Pharmacy Department, Marmara University, Istanbul, Turkey
| | - Aygül Köseoğlu
- Oncology Centre, Dr. Lütfi Kırdar Kartal Teaching and Research Hospital, Istanbul, Turkey
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Pizarro Â, Martins M, Simões J. Expanding Primary Care to Pharmaceutical Patient Care in Diabetes Mellitus Type 2 through the European Union’s Community Pharmacies, between 2008 and 2018: A Systematic Review. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000506261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Abstract
Factors contributing to therapeutic inertia related to patients' medication experiences include concerns about side effects and out-of-pocket costs, stigmatization for having diabetes, confusion about frequent changes in evidence-based guidelines, low health literacy, and social determinants of health. A variety of solutions to this multifactorial problem may be necessary, including integrating pharmacists into interprofessional care teams, using medication refill synchronization programs, maximizing time with patients to discuss fears and concerns, being cognizant of language used to discuss diabetes-related topics, and avoiding stigmatizing patients. Managing diabetes successfully is a team effort, and the full commitment of all team members (including patients) is required to achieve desired outcomes through an individualized approach.
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Affiliation(s)
| | - John E Begert
- School of Pharmacy, Pacific University Oregon, Hillsboro, OR
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Dwiputri AW, Pristianty L, Hermansyah A. Pharmacist contributions in the treatment of diabetes mellitus in Southeast Asia: a narrative review. J Basic Clin Physiol Pharmacol 2020; 30:/j/jbcpp.ahead-of-print/jbcpp-2019-0322/jbcpp-2019-0322.xml. [PMID: 31971912 DOI: 10.1515/jbcpp-2019-0322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/22/2019] [Indexed: 06/10/2023]
Abstract
Background The growing burden of diabetes mellitus (DM) in Southeast Asia puts pharmacists in the ideal position to provide management of DM. This narrative review aims to describe the evidence of pharmacist contribution in improving DM in Southeast Asia. Content A literature search was conducted to identify relevant research articles published from 2010 to 2018 in four databases (Scopus, Pubmed, MEDLINE, and Springerlink) describing pharmacist roles and activities intended to improve management of DM in Southeast Asian countries. Results were synthesized narratively and divided into three main sections: (1) the role of pharmacist in DM management, (2) the impact of pharmacist role, and (3) the barriers to the implementation of services in DM management. A total of 16 studies were identified, of which ten studies mentioned services that were conducted exclusively by a pharmacist and the remaining collaborated with other health professionals. A number of pharmacist services were reported including prevention, dispensing, medication review, drug information services, patient counselling and education, monitoring, follow-up, and referral. Barriers related to individual, organizational, and public recognition were described. Summary and outlook The Pharmacist can contribute to improve DM management in a variety of settings. Action research on pharmacist intervention in DM is recommended.
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Affiliation(s)
| | - Liza Pristianty
- Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Andi Hermansyah
- Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
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Khdour MR, Awadallah HB, Alnadi MA, Al-Hamed DH. Beliefs About Medicine and Glycemic Control Among Type 2 Diabetes Patients: A Cross-Sectional Study in West Bank, Palestine. J Prim Care Community Health 2020; 11:2150132720971919. [PMID: 33287616 PMCID: PMC7727042 DOI: 10.1177/2150132720971919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION To examine the mean differences between patient beliefs about medicine with reference to adherence and glycemic control. METHODS This study utilized a cross-sectional questionnaire-based approach. Adherence to medication was measured with the Morisky Green Levine Medication Adherence Scale (MGLS); glycemic control as the last HbA1c test value; and beliefs about medicine with the Beliefs about Medicines Questionnaire (BMQ). RESULTS According to MGLS scale, 220 (57.9%) of the diabetic patients were classified as high adherent to their medications and 160 (42.1%) were classified as low adherent. Patients had strong believes in their medication, the mean necessity score was significantly outweighed the mean concerns score (17.7 vs 14.4; P < .001). Low adherent patients had significantly more concerns about long term effect of medications (14.4 vs 13.8; P < .008). No significant mean differences were found between glycemic controlled and uncontrolled group regarding necessity or concern domains. CONCLUSION Assessing beliefs about medicine is crucial for recognizing patients at risk of low adherence, which offers a way to help patients with diabetes to achieve a better glycemic control.
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Cochran G, Chen Q, Field C, Seybert AL, Hruschak V, Jaber A, Gordon AJ, Tarter R. A community pharmacy-led intervention for opioid medication misuse: A small-scale randomized clinical trial. Drug Alcohol Depend 2019; 205:107570. [PMID: 31689641 PMCID: PMC6933550 DOI: 10.1016/j.drugalcdep.2019.107570] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Stemming the opioid epidemic requires testing novel interventions. Toward this goal, feasibility and acceptability of a Brief Motivational Intervention-Medication Therapy Management (BMI-MTM) intervention was examined along with its impact on medication misuse and concomitant health conditions. METHODS We conducted a two-group randomized trial in 2 community pharmacies. We screened patients for prescription opioid misuse at point-of-service using the Prescription Opioid Misuse Index. Participants were assigned to standard medication counseling (SMC) or SMC + BMI-MTM (referred to as BMI-MTM herein). BMI-MTM consists of a pharmacist-led medication counseling/brief motivational session and 8-weekly patient navigation sessions. Assessments were at baseline, 2-, and 3-months. Primary outcomes included feasibility, acceptability, and mitigation of opioid medication misuse. Secondary outcomes included pain and depression. Outcomes were analyzed with descriptive and multivariable statistics (intent-to-treat [ITT] and adjusted for number of sessions completed [NUMSESS]). RESULTS Thirty-two participants provided informed consent (74.4% consent rate; SMC n = 17, BMI-MTM n = 15; 3-month assessment retention ≥93%). Feasibility was demonstrated by all BMI-MTM recipients completing the pharmacist session and an average of 7 navigation sessions. BMI-MTM recipients indicated ≥4.2 (5 maximum) level of satisfaction with the pharmacist-led session, and 92.4% were satisfied with navigation sessions. Compared to SMC at 3-months, BMI-MTM recipients reported greater improvements in misuse (ITT: Adjusted Odds Ratio [AOR] = 0.13; 95% CI = 0.05, 0.35, p < 0.001. NUMSESS AOR = 0.05; 95% CI = 0.01, 0.25; p < 0.001), pain (ITT: В = 8.8, 95% CI=-0.95, 18.5, p = 0.08; NUMSESS: В = 14.0, 95% CI = 3.28, 24.8, p = 0.01), and depression (ITT: B= -0.44; 95% CI=-0.65, -0.22; p < 0.001. NUMSESS B= -0.64; 95% CI=-0.82, -0.46; p < 0.001). CONCLUSIONS BMI-MTM is a feasible misuse intervention associated with superior satisfaction and outcomes than SMC. Future research should test BMI-MTM in a large-scale, fully-powered trial.
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Affiliation(s)
- Gerald Cochran
- University of Utah, School of Medicine, Department of Internal Medicine, 30 N 1900 E, Room 4C104, Salt Lake City, Utah, 84132, USA; University of Pittsburgh, School of Social Work 2117 Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
| | - Qi Chen
- University of Pittsburgh, School of Social Work 2117 Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
| | - Craig Field
- University of Texas, El Paso, Department of Psychology, Psychology Building, Room 112 500 W University, El Paso, Texas, 79902, USA.
| | - Amy L Seybert
- University of Pittsburgh, School of Pharmacy, Department of Pharmacy and Therapeutics, 3501 Terrace St, Pittsburgh, PA, 15261, USA.
| | - Valerie Hruschak
- University of Pittsburgh, School of Social Work 2117 Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
| | - Amanda Jaber
- Falk Pharmacy, UPMC 3601 Fifth Ave, Pittsburgh, PA 15213, USA.
| | - Adam J Gordon
- University of Utah, School of Medicine, Department of Internal Medicine, 30 N 1900 E, Room 4C104, Salt Lake City, Utah, 84132, USA.
| | - Ralph Tarter
- University of Pittsburgh, School of Pharmacy, Department of Pharmaceutical Sciences, 3501 Terrace St, Pittsburgh, PA, 15261, USA.
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Nasution A, Dalimunthe A, Khairunnisa K. Pharmacists Intervention Reduced Drug-Related Problems in the Treatment of Patients with Type 2 Diabetes Mellitus. Open Access Maced J Med Sci 2019; 7:3856-3860. [PMID: 32127991 PMCID: PMC7048351 DOI: 10.3889/oamjms.2019.519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND: Type 2 Diabetes Mellitus (T2DM) remains as a global public health problem, including Indonesia due to its continuous increasing prevalence. AIM: To analyze the impact of pharmacist intervention on drug-related problems (DRPs) occurred in the management of patients with T2DM admitted to Tebing Tinggi Hospital (TTH), Indonesia, period March through August 2018. METHODS: This six-month retrospective prospective cohort study evaluated the impact of pharmacist intervention on the occurrence of DRPs in the management of patients with T2DM (n = 45) insured by Social Security Organizing Body in TTH, North Sumatera, Indonesia. The inclusion criteria were T2DM patients with age ≥ 18 years and under treatment of antidiabetic drugs. A questionnaire was used to assess the characteristics of the patients and antidiabetic drugs provided. The incidence of DRPs in groups with usual care for the previous three-month and with pharmacist interventions for the next three-month admissions were analyzed using Pharmaceutical Care Network Europe (PCNE) DRP classification system version 8.01 that consists of 3 primary domains for problems, 8 primary domains for causes, and 5 primary domains (PCNE, 2017) and trustable literatures. The obtained data were analyzed using descriptive statistics and paired t test in the program of Statistical Package for the Social Sciences version 19 (p < 0.05 was considered significant). RESULTS: Most (66.7%) of the patients were female. Their mean age was 61.96 ± 6.45 (years). The three most widely provided drugs were metformin, glimepirid, and gliclazide. Total incidence of DRPs in groups with: usual care, 128; intervention, 39. There was a significant difference between the incidence of DRPs in groups with usual care and intervention, p ≤ 0.001. CONCLUSION: Pharmacist intervention reduced the incidence of DRPs in the management of T2DM patients.
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Affiliation(s)
- Azizah Nasution
- Department of Pharmacology, Faculty Pharmacy, Universitas Sumatera Utara, Medan 20155, Indonesia
| | - Aminah Dalimunthe
- Department of Pharmacology, Faculty Pharmacy, Universitas Sumatera Utara, Medan 20155, Indonesia
| | - Khairunnisa Khairunnisa
- Department of Pharmacology, Faculty Pharmacy, Universitas Sumatera Utara, Medan 20155, Indonesia
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Lin CH, Tran NT, Muradian IK, Do NH, Lu QD, Tesema L, Henderson SO. Impact of a Pharmacist-Led Diabetes Clinic in a Correctional Setting. J Pharm Pract 2019; 34:596-599. [PMID: 31742483 DOI: 10.1177/0897190019888075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Incarcerated patients often have a high disease burden and poor access to care in the community. In an effort to ensure glycemic control and appropriate initiation of statin therapy for cardiovascular (CV) risk reduction, a pilot program of pharmacist-led diabetes clinic (PLDC) was implemented in a large inner-city jail. A pre-post study was conducted as a quality improvement initiative. Inclusion criteria were inmate-patients (IPs) diagnosed with type 2 diabetes mellitus, treated with oral antidiabetic medications, managed by PLDC, and with at least 2 glycosylated hemoglobin A1cs (HbA1c). The primary outcome was the change in HbA1c after PLDC. The secondary outcome was the frequency of statin therapy. A total of 240 IPs met the inclusion criteria. Mean HbA1c was 8.2% at baseline and 7.6% at the last follow-up encounter, a change of -0.7% (95% confidence interval [CI]: -0.41% to -0.93%). The most dramatic change was seen in the group with the highest initial HbA1c (HbA1c ≥ 10%), from a mean baseline HbA1c of 11.6% to 8.5%, a change of -3.1% (95% CI: -2.5% to -3.7%). IPs with an initial HbA1c between 7% and 9.9% showed a change in mean HbA1c from 8.4% to 8.0%, a change of -0.4% (95% CI: -0.1% to -0.7%). Of the 240 included IPs, 141 were not on a statin at baseline. The frequency of statin use increased by 50.4% after PLDC. PLDC significantly improved glycemic control and guideline concordance for CV risk reduction. Adding PLDC to multidisciplinary care teams has the potential to improve population health outcomes for this medically complex, yet underserved patient population.
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Affiliation(s)
- Cindy H Lin
- Correctional Health Services, 140483Los Angeles County Department of Health Services, Angeles, CA, USA
| | - Ngoc T Tran
- Correctional Health Services, 140483Los Angeles County Department of Health Services, Angeles, CA, USA
| | - Ibrahim K Muradian
- Correctional Health Services, 140483Los Angeles County Department of Health Services, Angeles, CA, USA
| | - Nguyen H Do
- Correctional Health Services, 140483Los Angeles County Department of Health Services, Angeles, CA, USA
| | - Quyen D Lu
- Correctional Health Services, 140483Los Angeles County Department of Health Services, Angeles, CA, USA
| | - Lello Tesema
- Correctional Health Services, 140483Los Angeles County Department of Health Services, Angeles, CA, USA
| | - Sean O Henderson
- Correctional Health Services, 140483Los Angeles County Department of Health Services, Angeles, CA, USA
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Catic T, Jusufovic R, Horozic D, Lekic L, Tabakovic V. Pharmacists' Attitudes and Role in Diabetes Management in Bosnia and Herzegovina. Med Arch 2019; 73:351-355. [PMID: 31819310 PMCID: PMC6885234 DOI: 10.5455/medarh.2019.73.351-355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/17/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Diabetes is the fastest growing chronic diseases worldwide and in Bosnia and Herzegovina. International standards for diabetes care have recognized the crucial role of pharmacists in diabetes management. Community pharmacists can provide services beyond medication dispensing inducing patient identification, assessment, education, referral, monitoring and behavioral counseling. Pharmacists' attitudes toward diabetes are generally positive but do not correlate with the degree of their involvement in diabetes management and frequency of providing diabetes-related services varied throughout countries. AIM To measure pharmacists' attitude toward diabetes management and to identify pharmacy services that are currently provided to patients with diabetes. MATERIAL AND METHODS We have conducted a descriptive, cross-sectional survey-based study among pharmacists from Bosnia and Herzegovina attending on of the conferences in May 2018. Majority of pharmacist attending such conferences are from community pharmacies across the whole country considering surveyed sample was representative. The questionnaire contained 3 different sections: a) participants' demographics, b) measured participants' attitude toward diabetes using the DAS-3 to measure participants' degree of agreement to 33 diabetes-related statements, on a 5-point Likert type scale and c) a list of possible diabetes patient support activities that could be delivered by pharmacists based on authors experience and available literature. RESULTS The majority of respondents (86,5%) were female and 53,8% work in private owned pharmacies. Interest in diabetes was indicated by 94,2% while 59,6% completed special diabetes continuing education in the past. All the respondents expressed positive attitudes in all DAS-3 with no significant difference between overall DAS-3 and subscale values. Provided services differ but mainly drug oriented and partially include comorbidity counseling. CONCLUSION Pharmacists had positive attitudes toward diabetes but they provided limited diabetes-related services to patients. Additional special education is needed.
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Affiliation(s)
- Tarik Catic
- University Sarajevo School of Science and Technology, Medical School, Sarajevo, Bosnia and Herzegovina
| | - Rasim Jusufovic
- University Sarajevo School of Science and Technology, Medical School, Sarajevo, Bosnia and Herzegovina
| | - Dzan Horozic
- Medical doctor, Sarajevo, Bosnia and Herzegovina
| | - Lana Lekic
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Vedad Tabakovic
- Pharmaceutical Society of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
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Pharmacy-led interventions to improve medication adherence among adults with diabetes: A systematic review and meta-analysis. Res Social Adm Pharm 2019; 15:1057-1067. [DOI: 10.1016/j.sapharm.2018.09.021] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/21/2018] [Accepted: 09/29/2018] [Indexed: 11/20/2022]
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Three Innovative Population Health Concepts for Patient Medical Homes to Improve Diabetes Care in Family Medicine. Can J Diabetes 2019; 43:433-436. [DOI: 10.1016/j.jcjd.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/03/2019] [Indexed: 11/23/2022]
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Boivin M. Role of the Pharmacist Certified Diabetes Educator Along the Type 2 Diabetes Care Continuum. Can J Diabetes 2019; 43:429-432. [DOI: 10.1016/j.jcjd.2019.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/06/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
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Liau JM. Diabetes medication therapy management: have you considered a home medicines review for your patients? JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2019. [DOI: 10.1002/jppr.1564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Aziz MM, Yang S, Masood I, Zhu S, Raza MA, Ji W, Anwar N, Saeed A, Fang Y. An assessment of counseling quality provided by community pharmacies to type 2 diabetic adult patients for oral therapy: a simulated patient study from Pakistan. Endocr J 2019; 66:233-239. [PMID: 30726787 DOI: 10.1507/endocrj.ej18-0429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study was conducted to assess quality of counseling provided to type 2 diabetic patients. For this cross-sectional study, a simulated patient method was applied in 562 selected community pharmacies of Punjab, Pakistan. A scenario for the metformin oral therapy was developed that illustrates direct counseling for adult diabetic patients. Counseling and communication skills were also assessed. Descriptive statistics and chi-square tests were used for analysis. Only 29.4% of simulated patients received medication counseling directly; 47.6% received it on request. About 32.8% of clients were referred to a physician without counseling. The most frequently provided information was dietary instruction (94.8%) and dose of therapy (84.5%). Only one quarter (25.3%) of simulated patients were asked about disease duration and similar rate (25.0%) was found for discussions of special warnings. The side effects, drug storage, drug-drug interactions and duration of therapy were ignored. Minimal information was provided about other medication during therapy (0.2%) and effect of medicine withdrawal (2.7%). About 59.5% simulated patients were instructed for compliance to medication. Counseling to type 2 diabetic patients in Pakistani community pharmacies is not very satisfactory. Pharmacies' staff have little focus on counseling. Professional training of staff could improve counseling and communication skills.
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Affiliation(s)
- Muhammad Majid Aziz
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, P. R. China
- Global Health Institute, Xi'an Jiaotong University, Xi'an, P. R. China
- Shaanxi Center for Health Reform and Development Research, Xi'an, P. R. China
| | - Shimin Yang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, P. R. China
- Global Health Institute, Xi'an Jiaotong University, Xi'an, P. R. China
- Shaanxi Center for Health Reform and Development Research, Xi'an, P. R. China
| | - Imran Masood
- Department of Pharmacy, Faculty of Pharmacy and Alternative Medicine, Railway Road Campus, Islamia University, Bahawalpur, Pakistan
| | - Shan Zhu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, P. R. China
- Global Health Institute, Xi'an Jiaotong University, Xi'an, P. R. China
- Shaanxi Center for Health Reform and Development Research, Xi'an, P. R. China
| | - Muhammad Ali Raza
- Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, P. R. China
- Global Health Institute, Xi'an Jiaotong University, Xi'an, P. R. China
- Shaanxi Center for Health Reform and Development Research, Xi'an, P. R. China
| | - Naveed Anwar
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Amna Saeed
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, P. R. China
- Global Health Institute, Xi'an Jiaotong University, Xi'an, P. R. China
- Shaanxi Center for Health Reform and Development Research, Xi'an, P. R. China
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Ferhati X, Matassini C, Fabbrini MG, Goti A, Morrone A, Cardona F, Moreno-Vargas AJ, Paoli P. Dual targeting of PTP1B and glucosidases with new bifunctional iminosugar inhibitors to address type 2 diabetes. Bioorg Chem 2019; 87:534-549. [PMID: 30928876 DOI: 10.1016/j.bioorg.2019.03.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/04/2019] [Accepted: 03/18/2019] [Indexed: 10/27/2022]
Abstract
The diffusion of type 2 diabetes (T2D) throughout the world represents one of the most important health problems of this century. Patients suffering from this disease can currently be treated with numerous oral anti-hyperglycaemic drugs, but none is capable of reproducing the physiological action of insulin and, in several cases, they induce severe side effects. Developing new anti-diabetic drugs remains one of the most urgent challenges of the pharmaceutical industry. Multi-target drugs could offer new therapeutic opportunities for the treatment of T2D, and the reported data on type 2 diabetic mice models indicate that these drugs could be more effective and have fewer side effects than mono-target drugs. α-Glucosidases and Protein Tyrosine Phosphatase 1B (PTP1B) are considered important targets for the treatment of T2D: the first digest oligo- and disaccharides in the gut, while the latter regulates the insulin-signaling pathway. With the aim of generating new drugs able to target both enzymes, we synthesized a series of bifunctional compounds bearing both a nitro aromatic group and an iminosugar moiety. The results of tests carried out both in vitro and in a cell-based model, show that these bifunctional compounds maintain activity on both target enzymes and, more importantly, show a good insulin-mimetic activity, increasing phosphorylation levels of Akt in the absence of insulin stimulation. These compounds could be used to develop a new generation of anti-hyperglycemic drugs useful for the treatment of patients affected by T2D.
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Affiliation(s)
- Xhenti Ferhati
- Department of Chemistry 'Ugo Schiff', University of Firenze, via della Lastruccia 3-13, Sesto Fiorentino, (FI), Italy
| | - Camilla Matassini
- Department of Chemistry 'Ugo Schiff', University of Firenze, via della Lastruccia 3-13, Sesto Fiorentino, (FI), Italy
| | - Maria Giulia Fabbrini
- Department of Chemistry 'Ugo Schiff', University of Firenze, via della Lastruccia 3-13, Sesto Fiorentino, (FI), Italy
| | - Andrea Goti
- Department of Chemistry 'Ugo Schiff', University of Firenze, via della Lastruccia 3-13, Sesto Fiorentino, (FI), Italy; Associated with Consorzio Interuniversitario Nazionale di ricerca in Metodologie e Processi Innovativi di Sintesi (CINMPIS), Italy
| | - Amelia Morrone
- Paediatric Neurology Unit and Laboratories, Neuroscience Department, Meyer Children's Hospital, and Department of Neurosciences, Pharmacology and Child Health. University of Florence, Viale Pieraccini n. 24, 50139 Firenze, Italy
| | - Francesca Cardona
- Department of Chemistry 'Ugo Schiff', University of Firenze, via della Lastruccia 3-13, Sesto Fiorentino, (FI), Italy; Associated with Consorzio Interuniversitario Nazionale di ricerca in Metodologie e Processi Innovativi di Sintesi (CINMPIS), Italy.
| | - Antonio J Moreno-Vargas
- Departamento de Química Orgánica, Facultad de Química, Universidad de Sevilla, n/Prof. García González 1, E-41012 Sevilla, Spain
| | - Paolo Paoli
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy.
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Catic T, Jusufovic R. Use of Food Supplements in Diabetes Mellitus Treatment in Bosnia and Herzegovina from the Pharmacists Perspective. Mater Sociomed 2019; 31:141-145. [PMID: 31452641 PMCID: PMC6690309 DOI: 10.5455/msm.2019.31.141-145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Food supplements utilization is showing increasing trend among healthy as well as chronic disease population. Diabetes as a pandemic disease is treated by different interventions and traditional pharmacological treatment, but also utilization of natural products and food supplements (FS) are becoming important. Role of the pharmacist in diabetes management includes different interventions like counseling and recommendation of FS. Aim To explore current trends in dietary supplements utilization among diabetic patients from the pharmacists' perspective, pharmacists' attitudes and knowledge about this group of products and suggest future directions related to this issue. Methods We have analyzed pharmacists' perception of FS utilization for diabetes and its complication treatment by conducting online survey. The survey was developed by authors based on research aim and published literature. Results It has been found that 72% of patients with diabetes are purchasing different FS and that they are willing to pay between 5,0-15,0 EUR per visit for this products. Even in majority of cases pharmacists proactively advice patients about FS selection they identify need for specific education in this field in order to strengthen their competencies and competitiveness. Pharmacists also identified need for FS specially formulated and intended for blood glucose controls and most often diabetes complications and related conditions. Conclusion This is the first study in this field conducted in Bosnia and Herzegovina suggesting further activities and research of this topic.
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Affiliation(s)
- Tarik Catic
- Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Rasim Jusufovic
- Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
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Alsairafi Z, Waheedi M, Alsaleh F. The perspectives of patients and physicians on the role of pharmacists in improving medication adherence in type 2 diabetes: a qualitative study. Patient Prefer Adherence 2019; 13:1527-1543. [PMID: 31571836 PMCID: PMC6750862 DOI: 10.2147/ppa.s218068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/21/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Pharmacy practice has been expanded to include responsibility for the outcomes of medication therapy. However, in developing countries the pharmacist's role is still limited to dispensing medications. The aim of this study is to explore the perspectives of patients and physicians on the pharmacist's role in improving medication adherence in type 2 diabetes. METHODS Data were collected via semi-structured interviews with patients and physicians. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS A total of 40 patients and 21 physicians were interviewed. The interviews revealed different pharmacy-related issues that negatively affected patients' adherence, such as a lack of pharmacist counselling and inappropriate scheduling of refills. Various recommendations to improve adherence were emphasised such as dedicating some pharmacists to counselling patients and providing pharmacists with the appropriate training. CONCLUSION From the perspectives of patients and physicians, the pharmacist's role in the management of type 2 diabetes is still limited to dispensing medications. In order to improve medication adherence and consequently patient outcomes, policy-makers need to be aware of the importance of supporting pharmacists and providing them with the appropriate training.
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Affiliation(s)
- Zahra Alsairafi
- Department of Pharmacy Practice, Kuwait University, Faculty of Pharmacy, Hawalli, Kuwait
| | - Mohammad Waheedi
- Department of Pharmacy Practice, Kuwait University, Faculty of Pharmacy, Hawalli, Kuwait
- Correspondence: Mohammad Waheedi PO Box 24923, Safat, Hawalli 13110, KuwaitTel +965 6 622 3629Email
| | - Fatemah Alsaleh
- Department of Pharmacy Practice, Kuwait University, Faculty of Pharmacy, Hawalli, Kuwait
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Westrick SC, Hohmann LA, Hastings TJ. Pharmacy technicians—A critical element to facilitate implementation of pharmacist-provided services. J Am Pharm Assoc (2003) 2018; 58:133-134. [DOI: 10.1016/j.japh.2018.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Deters MA, Laven A, Castejon A, Doucette WR, Ev LS, Krass I, Mehuys E, Obarcanin E, Schwender H, Laeer S. Effective Interventions for Diabetes Patients by Community Pharmacists: A Meta-analysis of Pharmaceutical Care Components. Ann Pharmacother 2017; 52:198-211. [PMID: 28948839 DOI: 10.1177/1060028017733272] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate randomized controlled trials (RCTs) that included interventions provided by community pharmacists for patients with type 1 and 2 diabetes, the analysis of each component of the intervention(s), and the description of the training that the pharmacists received. DATA SOURCES The literature research was conducted in PubMed and in the Cochrane Central Register of Controlled Trials (January 2000 to April 2016) for RCTs with interventions provided by community pharmacists for patients with diabetes. Corresponding authors were contacted about missing data and intervention and training design. STUDY SELECTION AND DATA EXTRACTION RCTs published in English or German were included if pharmaceutical care or medication therapy management was conducted by community pharmacists with diabetes patients. Basic information, intervention and training design data were extracted. DATA SYNTHESIS The literature research resulted in 11 eligible studies for further analysis. The corresponding authors of 6 studies responded to our request and sent their raw data. The calculated meta-analytical effect of 640 analyzed patients was a hemoglobin A1C (A1C) difference of -0.66%, with a 95% CI of -0.86% to -0.45%. The analysis revealed that most intervention elements had a significant positive meta-analytical effect on the A1C values. CONCLUSIONS Our meta-analysis suggests that community pharmacist-led interventions can improve glycemic control in patients with type 1 and 2 diabetes. The most effective intervention components were patient centered and interdisciplinary. Pharmaceutical care interventions should, therefore, include the following components: sending feedback to the physician, setting individual goals, reviewing medication, and assessing patients' health beliefs and medication knowledge.
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Affiliation(s)
- Maira Anna Deters
- 1 Heinrich-Heine-University Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Anna Laven
- 1 Heinrich-Heine-University Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Ana Castejon
- 2 Nova Southeastern University, Fort Lauderdale, FL, USA
| | | | | | - Ines Krass
- 5 University of Sydney, New South Wales, Australia
| | | | - Emina Obarcanin
- 1 Heinrich-Heine-University Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Holger Schwender
- 1 Heinrich-Heine-University Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
| | - Stephanie Laeer
- 1 Heinrich-Heine-University Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
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