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Effects of a pharmaceutical care model on medication adherence and glycemic control of people with type 2 diabetes

Authors Chung WW, Chua SS, Lai PSM, Chan SP

Received 22 April 2014

Accepted for publication 12 June 2014

Published 4 September 2014 Volume 2014:8 Pages 1185—1194

DOI https://doi.org/10.2147/PPA.S66619

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Wen Wei Chung,1,2 Siew Siang Chua,1 Pauline Siew Mei Lai,3 Siew Pheng Chan4

1Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 2Pharmacy Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia; 3Department of Primary Care Medicine, University Malaya Primary Care Research Group, 4Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

Background: Diabetes mellitus is a lifelong chronic condition that requires self-management. Lifestyle modification and adherence to antidiabetes medications are the major determinants of therapeutic success in the management of diabetes.
Purpose: To assess the effects of a pharmaceutical care (PC) model on medication adherence and glycemic levels of people with type 2 diabetes mellitus.
Patients and methods: A total of 241 people with type 2 diabetes were recruited from a major teaching hospital in Malaysia and allocated at random to the control (n=121) or intervention (n=120) groups. Participants in the intervention group received PC from an experienced pharmacist, whereas those in the control group were provided the standard pharmacy service. Medication adherence was assessed using the Malaysian Medication Adherence Scale, and glycemic levels (glycated hemoglobin values and fasting blood glucose [FBG]) of participants were obtained at baseline and after 4, 8, and 12 months.
Results: At baseline, there were no significant differences in demographic data, medication adherence, and glycemic levels between participants in the control and intervention groups. However, statistically significant differences in FBG and glycated hemoglobin values were observed between the control and intervention groups at months 4, 8, and 12 after the provision of PC (median FBG, 9.0 versus 7.2 mmol/L [P<0.001]; median glycated hemoglobin level, 9.1% versus 8.0% [P<0.001] at 12 months). Medication adherence was also significantly associated with the provision of PC, with a higher proportion in the intervention group than in the control group achieving it (75.0% versus 58.7%; P=0.007).
Conclusion: The provision of PC has positive effects on medication adherence as well as the glycemic control of people with type 2 diabetes. Therefore, the PC model used in this study should be duplicated in other health care settings for the benefit of more patients with type 2 diabetes.

Keywords: pharmaceutical care, medication adherence, glycemic control, type 2 diabetes mellitus
 

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