Effectiveness of medication review services on diabetes self-care in primary care patients-A randomised controlled study

Abstract

Background Though self-care is a critical component of diabetes management, it is unknown whether pharmacist-run medication review service (MRS) can be an additional intervention to enhance self-care in diabetic patients. Objectives Hence, this study aims to determine the effectiveness of MRS in addition to existing care protocol in improving self-care in diabetic patients. Methods This randomised controlled study was conducted in five polyclinics from December 2014 to October 2016. Participants were 40 to 80 years of age and had been diagnosed with type 2 diabetes. These participants were prescribed with five or more chronic medications, of which at least one was an antidiabetic medication, by the primary healthcare centres’ doctors. The participants were randomly recruited into the intervention or control arm. A self-developed questionnaire which incorporated the validated Diabetes Self-Management Questionnaire (DSMQ) was administered face-to-face by the study team to the participants prior to and after MRS. MRS was not administered to participants in the control group. Results A total of 221 participants completed the follow up. There were 105 participants in the control arm and 116 in the intervention arm. The DSMQ Sum Scale score of the control group improved by 0.16 ± 1.11 ( p = 0.136) while the intervention group improved by 0.40 ± 0.99 ( p = 0.000). Participants in the intervention group reported a better improvement in their self-care of diabetes, specifically in glucose management ( p = 0.003), dietary control ( p = 0.096) and physical activity ( p = 0.003). Conclusions Pharmacist-run MRS can be included in addition to existing care to improve self-care in patients with diabetes.