Abstract
Background and Objectives: Globally, diabetes Mellitus (DM) is a life-threatening disease that, if it remains uncontrolled, can lead to mortality or serious complications. Despite the noticeable benefits of clinical pharmacist in managing diabetes, some institutions in Saudi Arabia are reluctant to establish a pharmacist-led diabetic clinic for monitoring and follow-up. The objective of this study is to assess the glycemic control by comparing the reduction in hemoglobin A1c (HbA1c) percentage between patients followed in the pharmacist-led diabetic clinics vs. those followed in physician-led diabetic clinics. Materials and Methods: A retrospective observational study with a 12-month follow-up were used to detect the difference in the glycemic control by comparing the reduction in HbA1c percentage from the baseline, and average changes in HbA1c, fasting blood glucose (FBG), blood pressure (BP), and lipid panel between the two groups. The level of self-care was assessed by Summary of Diabetes Self-Care Activities (SDSCA) Questionnaire. Results: The study involved 52 patients who visited the diabetic clinic at a community teaching hospital. Exactly 24 patients were followed by the pharmacist-led diabetic clinics, while 28 were followed by physician-led diabetic clinics. HbA1c baseline was 8.7% and 8.4% for pharmacist and physician, respectively. The average difference in HbA1c for the pharmacist-led diabetic clinics vs. the physician-led diabetic clinics was not statistically significant (8.67 vs. 8.56; p = 0.77). Moreover, no difference in the glucose profile, lipid panel, and blood pressure were seen between the two groups. However, the median HbA1c change from baseline between the two groups significantly favored the pharmacist-led clinic (0.7 vs. 0.003; p = 0.04).The average of responses in all four aspects of the SDSCA (diet, exercise, blood sugar testing, and foot care) was also higher among patients in the pharmacist-led diabetic clinic. Conclusions: Pharmacist-led diabetic clinics for glycemic control and follow-up showed efficient results that encourage the comprehensive and integral inter-professional patient care.
Highlights
Statistics show that Saudi Arabia is at the second and seventh rank in the rate of diabetes in the Middle East and the world, respectively, with approximately 7 million of its people having diabetes, and more than 3 million having a significant risk for developing diabetes [1]
The aim of this study is to assess the difference in diabetic management utilizing hemoglobin A1c (HbA1c) in clinics managed by clinical pharmacists vs. clinics managed by physicians
A retrospective chart review study with 12-month follow-up from 4/2018 to 12/2020 was used to investigate the difference in management of diabetes mellitus between the patients followed in the pharmacist-led diabetic clinics vs. those followed in physician-led diabetic clinics
Summary
Statistics show that Saudi Arabia is at the second and seventh rank in the rate of diabetes in the Middle East and the world, respectively, with approximately 7 million of its people having diabetes, and more than 3 million having a significant risk for developing diabetes [1]. These facts make the diabetes disease a growing global health concern [2]. The involvement of clinical pharmacists in diabetes management to collaboratively assist in caring for those patients remains underutilized [3,4,5]. The multidisciplinary management of diabetes is becoming essential
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