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Abstract
Type 2 diabetes mellitus (T2D) is responsible for an important premature mortality. Pharmacists involved in community-based pharmaceutical care services could help patients with diabetes through education and management as they participate in their regular and long-term care. This meta-analysis aimed to evaluate the association between interventions led by pharmacists in the primary care setting and mean change in HbA1c levels. Randomized controlled trials and quasi-experimental studies with a control group were included. Standardized mean differences (SMD) and their 95% confidence intervals (95% CI) were calculated to compare the mean change in HbA1c values between baseline and end of the intervention in each group. Subgroup analyses were performed to explore heterogeneity. Twelve articles were included. The results showed that pharmacist’s interventions significantly reduced HbA1c compared to usual care with an overall SMD of −0.67 (95% CI = [−0.87; −0.48], p < 0.0001). Even if no significant difference between subgroups were found, the reduction of HbA1c seemed more important when baseline HbA1c was ≥8.5%, the intervention occurred monthly, in a primary care center and in countries with a lower human development index. Our results suggest that pharmacists-led interventions in the primary care setting can improve glycemic control for adults with T2D.
Highlights
IntroductionDiabetes mellitus is a chronic disease that affects an increasing number of people around the world
Published: 8 March 2022Diabetes mellitus is a chronic disease that affects an increasing number of people around the world
In every meta-analysis identified about pharmacists’ interventions and type 2 diabetes mellitus (T2D), references were checked for potential additional studies
Summary
Diabetes mellitus is a chronic disease that affects an increasing number of people around the world. According to a World Health Organization (WHO) report, its agestandardized prevalence worldwide skyrocketed from 4.7% of the adult population in 1980 to 8.5% in 2014, representing 422 million people [1]. The main risk factors for T2D are familial history of diabetes, sedentary lifestyle and obesity [2]. Diabetes mellitus is responsible for a staggering premature mortality and leads to early morbidity. Guidelines have historically selected glycemic control as the main outcome measure for diabetes mellitus care. Glycated hemoglobin (HbA1c) reflects the mean blood sugar level for the last three months and the American Diabetes Association (ADA) recommends its measurement at least twice a year [4]. Hyperglycemia is significantly associated with diabetes risks for complication especially microvascular.
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