Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study
Introduction Epidemiological studies have reported that diabetes‐related complications increase after 5 years of uncontrolled/suboptimal metabolic control. The risk of experiencing diabetes‐related microvascular diseases usually spike after 10 years of uncontrolled diabetes. Objectives The objective...
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| Veröffentlicht in: | JAACP : Journal of the American College of Clinical Pharmacy 2021-06, Vol.4 (6), p.680-688 |
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| creator | Xu, Yingqi Gallagher, Paul J. Tan, Cheryl W. Y. Tsou, Keith Y. K. Tan, David H. Y. Ramaya, Henry Lee, Joyce Y.‐C. |
| description | Introduction
Epidemiological studies have reported that diabetes‐related complications increase after 5 years of uncontrolled/suboptimal metabolic control. The risk of experiencing diabetes‐related microvascular diseases usually spike after 10 years of uncontrolled diabetes.
Objectives
The objective of this study was to evaluate the impact of team‐based pharmaceutical care on glycemic control, self‐care, diabetes‐dependent quality of life, and productivity loss in patients with long‐standing diabetes (≥5 years).
Methods
This was a prospective, multicenter, randomized, controlled study. Patients with a glycosylated hemoglobin (HbA1c) > 7%, long‐standing diabetes defined as having a disease duration of at least 5 years, and polypharmacy defined as taking 5 or more chronic medications were included in the study. Patients in the intervention arm received team‐based pharmaceutical care regularly while patients in the control arm received physician‐centered care. Patients' humanistic outcomes were followed for 6 months.
Results
A total of 248 patients (126 intervention and 122 control) were included in the study. In addition to improved glycemic control observed in the intervention arm (mean difference: 0.44%, P = .003, 95% confidence interval: [0.15, 0.73]), the intervention arm showed significant improvements in overall self‐care level (+0.36, 95% confidence interval: [0.01, 0.72], P = .045) and self‐monitoring of blood glucose (+1.87, 95% confidence interval: [1.00, 2.99], P |
| doi_str_mv | 10.1002/jac5.1425 |
| format | Article |
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Epidemiological studies have reported that diabetes‐related complications increase after 5 years of uncontrolled/suboptimal metabolic control. The risk of experiencing diabetes‐related microvascular diseases usually spike after 10 years of uncontrolled diabetes.
Objectives
The objective of this study was to evaluate the impact of team‐based pharmaceutical care on glycemic control, self‐care, diabetes‐dependent quality of life, and productivity loss in patients with long‐standing diabetes (≥5 years).
Methods
This was a prospective, multicenter, randomized, controlled study. Patients with a glycosylated hemoglobin (HbA1c) > 7%, long‐standing diabetes defined as having a disease duration of at least 5 years, and polypharmacy defined as taking 5 or more chronic medications were included in the study. Patients in the intervention arm received team‐based pharmaceutical care regularly while patients in the control arm received physician‐centered care. Patients' humanistic outcomes were followed for 6 months.
Results
A total of 248 patients (126 intervention and 122 control) were included in the study. In addition to improved glycemic control observed in the intervention arm (mean difference: 0.44%, P = .003, 95% confidence interval: [0.15, 0.73]), the intervention arm showed significant improvements in overall self‐care level (+0.36, 95% confidence interval: [0.01, 0.72], P = .045) and self‐monitoring of blood glucose (+1.87, 95% confidence interval: [1.00, 2.99], P < .001) compared with the control arm. There were no significant differences in the changes in diabetes‐associated quality of life and overall work impairment between the two arms. A significant difference in activity impairment (affected productivity in regular unpaid activity) between the two arms was found, with 43.3% impairment having occurred in the control group vs 27.9% in the intervention group (P = .047).
Conclusion
Team‐based pharmaceutical care significantly improved overall self‐care and glycemia without deteriorating quality of life and incurring productivity loss. Our findings highlighted the value of team‐based pharmaceutical care in managing diabetes‐experienced patients.</description><identifier>ISSN: 2574-9870</identifier><identifier>EISSN: 2574-9870</identifier><identifier>DOI: 10.1002/jac5.1425</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>pharmaceutical care ; productivity ; quality of life ; self‐care ; type 2 diabetes mellitus</subject><ispartof>JAACP : Journal of the American College of Clinical Pharmacy, 2021-06, Vol.4 (6), p.680-688</ispartof><rights>2021 Pharmacotherapy Publications, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2695-54f53f5f84d4bf6c7cef643122a65d0edbd6c05431ea78e37f664a8f2e83eb73</citedby><cites>FETCH-LOGICAL-c2695-54f53f5f84d4bf6c7cef643122a65d0edbd6c05431ea78e37f664a8f2e83eb73</cites><orcidid>0000-0002-3923-2509 ; 0000-0002-6814-6298</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjac5.1425$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjac5.1425$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids></links><search><creatorcontrib>Xu, Yingqi</creatorcontrib><creatorcontrib>Gallagher, Paul J.</creatorcontrib><creatorcontrib>Tan, Cheryl W. Y.</creatorcontrib><creatorcontrib>Tsou, Keith Y. K.</creatorcontrib><creatorcontrib>Tan, David H. Y.</creatorcontrib><creatorcontrib>Ramaya, Henry</creatorcontrib><creatorcontrib>Lee, Joyce Y.‐C.</creatorcontrib><title>Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study</title><title>JAACP : Journal of the American College of Clinical Pharmacy</title><description>Introduction
Epidemiological studies have reported that diabetes‐related complications increase after 5 years of uncontrolled/suboptimal metabolic control. The risk of experiencing diabetes‐related microvascular diseases usually spike after 10 years of uncontrolled diabetes.
Objectives
The objective of this study was to evaluate the impact of team‐based pharmaceutical care on glycemic control, self‐care, diabetes‐dependent quality of life, and productivity loss in patients with long‐standing diabetes (≥5 years).
Methods
This was a prospective, multicenter, randomized, controlled study. Patients with a glycosylated hemoglobin (HbA1c) > 7%, long‐standing diabetes defined as having a disease duration of at least 5 years, and polypharmacy defined as taking 5 or more chronic medications were included in the study. Patients in the intervention arm received team‐based pharmaceutical care regularly while patients in the control arm received physician‐centered care. Patients' humanistic outcomes were followed for 6 months.
Results
A total of 248 patients (126 intervention and 122 control) were included in the study. In addition to improved glycemic control observed in the intervention arm (mean difference: 0.44%, P = .003, 95% confidence interval: [0.15, 0.73]), the intervention arm showed significant improvements in overall self‐care level (+0.36, 95% confidence interval: [0.01, 0.72], P = .045) and self‐monitoring of blood glucose (+1.87, 95% confidence interval: [1.00, 2.99], P < .001) compared with the control arm. There were no significant differences in the changes in diabetes‐associated quality of life and overall work impairment between the two arms. A significant difference in activity impairment (affected productivity in regular unpaid activity) between the two arms was found, with 43.3% impairment having occurred in the control group vs 27.9% in the intervention group (P = .047).
Conclusion
Team‐based pharmaceutical care significantly improved overall self‐care and glycemia without deteriorating quality of life and incurring productivity loss. Our findings highlighted the value of team‐based pharmaceutical care in managing diabetes‐experienced patients.</description><subject>pharmaceutical care</subject><subject>productivity</subject><subject>quality of life</subject><subject>self‐care</subject><subject>type 2 diabetes mellitus</subject><issn>2574-9870</issn><issn>2574-9870</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kE1OwzAQhSMEEqiw4AazRaLU-XGSsqsqflWJDftoYo-pUWxXsaOqrDgCp-FAnASHsmDDakZvvnkzeklynrKrlLFs9oqCX6VFxg-Sk4xXxXReV-zwT3-cnHn_yhhL53lRp-VJ8vlgNigCOAWB0Hy9f7ToScJmjb1BQUPQAjsQ2BM4C2FNsB4MWu3jANwQhDPkAY2zL7DBoMkGD1sd1tBFKfr5gFbqOJUaWwrkr2FhQdtAvTaAFrud1358AKGPqDP6jeQlCGdD77pu7M3QxXM07oAPg9ydJkcKO09nv3WSPN_ePC_vp6unu4flYjUVWTnnU14oniuu6kIWrSpFJUiVRZ5mGZZcMpKtLAXjUSGsasorVZYF1iqjOqe2yifJxd5W9M77nlSziU9jv2tS1oyRN2PkzRh5ZGd7dqs72v0PNo-LJf_Z-AY-TIno</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Xu, Yingqi</creator><creator>Gallagher, Paul J.</creator><creator>Tan, Cheryl W. Y.</creator><creator>Tsou, Keith Y. K.</creator><creator>Tan, David H. Y.</creator><creator>Ramaya, Henry</creator><creator>Lee, Joyce Y.‐C.</creator><general>John Wiley & Sons, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-3923-2509</orcidid><orcidid>https://orcid.org/0000-0002-6814-6298</orcidid></search><sort><creationdate>202106</creationdate><title>Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study</title><author>Xu, Yingqi ; Gallagher, Paul J. ; Tan, Cheryl W. Y. ; Tsou, Keith Y. K. ; Tan, David H. Y. ; Ramaya, Henry ; Lee, Joyce Y.‐C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2695-54f53f5f84d4bf6c7cef643122a65d0edbd6c05431ea78e37f664a8f2e83eb73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>pharmaceutical care</topic><topic>productivity</topic><topic>quality of life</topic><topic>self‐care</topic><topic>type 2 diabetes mellitus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xu, Yingqi</creatorcontrib><creatorcontrib>Gallagher, Paul J.</creatorcontrib><creatorcontrib>Tan, Cheryl W. Y.</creatorcontrib><creatorcontrib>Tsou, Keith Y. K.</creatorcontrib><creatorcontrib>Tan, David H. Y.</creatorcontrib><creatorcontrib>Ramaya, Henry</creatorcontrib><creatorcontrib>Lee, Joyce Y.‐C.</creatorcontrib><collection>CrossRef</collection><jtitle>JAACP : Journal of the American College of Clinical Pharmacy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Yingqi</au><au>Gallagher, Paul J.</au><au>Tan, Cheryl W. Y.</au><au>Tsou, Keith Y. K.</au><au>Tan, David H. Y.</au><au>Ramaya, Henry</au><au>Lee, Joyce Y.‐C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study</atitle><jtitle>JAACP : Journal of the American College of Clinical Pharmacy</jtitle><date>2021-06</date><risdate>2021</risdate><volume>4</volume><issue>6</issue><spage>680</spage><epage>688</epage><pages>680-688</pages><issn>2574-9870</issn><eissn>2574-9870</eissn><abstract>Introduction
Epidemiological studies have reported that diabetes‐related complications increase after 5 years of uncontrolled/suboptimal metabolic control. The risk of experiencing diabetes‐related microvascular diseases usually spike after 10 years of uncontrolled diabetes.
Objectives
The objective of this study was to evaluate the impact of team‐based pharmaceutical care on glycemic control, self‐care, diabetes‐dependent quality of life, and productivity loss in patients with long‐standing diabetes (≥5 years).
Methods
This was a prospective, multicenter, randomized, controlled study. Patients with a glycosylated hemoglobin (HbA1c) > 7%, long‐standing diabetes defined as having a disease duration of at least 5 years, and polypharmacy defined as taking 5 or more chronic medications were included in the study. Patients in the intervention arm received team‐based pharmaceutical care regularly while patients in the control arm received physician‐centered care. Patients' humanistic outcomes were followed for 6 months.
Results
A total of 248 patients (126 intervention and 122 control) were included in the study. In addition to improved glycemic control observed in the intervention arm (mean difference: 0.44%, P = .003, 95% confidence interval: [0.15, 0.73]), the intervention arm showed significant improvements in overall self‐care level (+0.36, 95% confidence interval: [0.01, 0.72], P = .045) and self‐monitoring of blood glucose (+1.87, 95% confidence interval: [1.00, 2.99], P < .001) compared with the control arm. There were no significant differences in the changes in diabetes‐associated quality of life and overall work impairment between the two arms. A significant difference in activity impairment (affected productivity in regular unpaid activity) between the two arms was found, with 43.3% impairment having occurred in the control group vs 27.9% in the intervention group (P = .047).
Conclusion
Team‐based pharmaceutical care significantly improved overall self‐care and glycemia without deteriorating quality of life and incurring productivity loss. Our findings highlighted the value of team‐based pharmaceutical care in managing diabetes‐experienced patients.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><doi>10.1002/jac5.1425</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3923-2509</orcidid><orcidid>https://orcid.org/0000-0002-6814-6298</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | pharmaceutical care productivity quality of life self‐care type 2 diabetes mellitus |
| title | Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study |
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