Research in Social and Administrative Pharmacy
Original ResearchSafe and effective use of medicines for patients with type 2 diabetes – A randomized controlled trial of two interventions delivered by local pharmacies
Section snippets
Background
Type 2 diabetes is one of the most prevalent chronic diseases affecting 350 million patients worldwide in 2011.1 In Denmark, 5.7% of the population – 320,545 persons – were diagnosed with diabetes in 2012.2 In 2005, a health technology assessment estimated that 100,000–150,000 were type 2 diabetes patients, but the real number of cases was estimated to be considerably higher (200,000–300,000) with 10,000–20,000 new cases each year.3 202,600 patients had a medicine against type 2 diabetes
Objectives
The aim of the study was to investigate whether a comprehensive and a brief individually targeted intervention for patients with type 2 diabetes could improve implementation of drug therapy in Danish community pharmacies. The intervention intended to give patients more competence and support to improve adherence and self-management in order to reach treatment goals for diabetes and blood pressure as well as goals for patient-perceived outcomes.
Methods
This study was designed as an RCT and included a comprehensive process evaluation. The RCT aimed to test two interventions for improving implementation of drug therapy in community pharmacies in the county of Funen in Denmark. In 2006, Funen had a mixed rural and urban population of 478,347 inhabitants, or approximately 9% of the Danish population.29
Results
Five pharmacies were included in the trial; five pharmacists and five pharmaconomists, and 205 patients met the inclusion criteria and were randomly allocated into three groups; 39 to the basic intervention (BI) group, 41 to the extended intervention (EI) group, and 125 to the control (C) group (Fig. 2). The patients were on average 62.6 years of age, 61.0% were males, and they were on average taking 4.7 drugs. No statistically significant differences in demographic or outcome variables were
Discussion
The study showed improvement in outcomes of patient health, well-being, knowledge and satisfaction as a result of the interventions – in particular for the EI group patients. Pharmacy staff reported satisfaction with their delivery of the intervention, but wished more involvement from the patients' GPs. Thus, a program comprising patient narratives, problem and resource identification, and multi-dimensional individually tailored patient medication management solutions seems to be an appropriate
Conclusion
The study showed improvement in patient health, well-being, knowledge, and satisfaction as a result of the interventions. This was in particular evident for patients in the EI group. Pharmacy staff reported satisfaction with their delivery of the interventions, but would have liked further involvement from the patients' GPs.
Thus a program comprising patient narratives, problem and resource identification, and multi-dimensional individually tailored patient medication management solutions seems
Acknowledgments
The project was supported financially by the Danish Health and Medicines Authority, Pharmadanmark, the Danish Association of Pharmaconomists, the Association of Danish Pharmacies and Pharmakon, and the Danish College of Pharmacy Practice.
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