Meta-analysis of the impact of pharmaceutical care on the outcome of gestational diabetes

Abstract

ObjectivePharmaceutical care is based on pharmacy, effective organization, and the management of drugs and patients throughout the medication process, to promote the scientific and rational use of drugs. This study evaluated the clinical application value of pharmaceutical care in gestational diabetes mellitus through meta-analysis. MethodsUsing “gestational diabetes mellitus + pharmacist/pharmaceutical care/pharmaceutical service” as the search term, the CNKI, Wanfang, VIP, PubMed, and Wed of Science databases were searched from the establishment of the database to September 1, 2022. Quality assessment and meta-analysis were performed on the randomized controlled trial (RCTs) that met the inclusion conditions. ResultsA total of 1 092 patients were included from nine studies. The results showed that pharmaceutical care could improve the incidence of adverse drug events, medication compliance, medication deviation, satisfaction rate of blood glucose control, pregnancy-induced hypertension, polyhydramnios, premature membrane rupture, macrosomia, premature delivery, neonatal hypoglycemia, and neonatal asphyxia [(P<0.000 1)][relative risk degree (RR)=0.63, P<0.000 1], 95% confidence interval (CI) (0.52–0.76); RR=1.18, 95%CI (1.11–1.26); RR=0.65, 95%CI (0.56,0–76); RR=1.20, 95%CI (1.11–1.29); RR=0.28, 95%CI (0.17–0.44); RR=0.29, 95%CI (0.18–0.45); RR=0.24, 95%CI (0.13–0.46); RR=0.32, 95%CI (0.20–0.52); RR=0.35, 95%CI (0.24–0.52); RR=0.38, 95%CI (0.25–0.58); RR=0.36, 95%CI (0.23–0.56); RR=0.29, 95%CI (0.17–0.49), respectively]. In the pharmaceutical care group, the rate of mastery of self-management skills, the incidence of neonatal hyperbilirubinemia, and the incidence of fetal distress were all better than those in the traditional medical care group, the difference was statistically significant (0.000 01<P<=0.05) [RR=1.35, 95%CI (1.11–1.64), P<0.003; RR=0.46, 95%CI (0.22–0.93), P<0.05; RR=0.24, 95%CI (0.13–0.46), P<0.000 1]. After excluding the articles with high heterogeneity, the analysis showed that gestational diabetes women in the pharmaceutical care group had higher rates of self-management skills, cesarean section, and neonatal hyperbilirubinemia than those in the traditional medical care group; these differences were statistically significant (P<0.000 01) [RR=1.45, 95%CI (1.27–1.67); RR=0.73, 95%CI (0.64–0.84); RR=0.32, 95%CI (0.18–0.58)]. ConclusionPharmaceutical care can improve the maternal and fetal outcomes of gestational diabetes mellitus.