Pharmacist’s interventions to improve clinical outcomes in patients with type 2 diabetes mellitus: Nyala City, South Darfur State, Sudan

Abstract

Prospective randomized controlled interventional (pre and post) clinical trial aimed to examine impact of pharmacist’s interventions (during 1 year follow-up) on diabetes clinical outcomes of patients with type 2 diabetes in Nyala City, Sudan. Three hundred patients (200 intervention and 100 control groups) with type 2 diabetes were clinically evaluated for diabetes care contents before and after implementation of diabetes care international guidelines from Institute for Clinical Systems Improvement (ICSI). We measured patient’s general and diabetes satisfaction level regarding diabetes care, by using Patient Satisfaction (PSQ-18) and Diabetes Satisfaction (DSQ) Questionnaires. Diabetes care elements were compared against international guidelines to achieve target goals of blood glucose and HBA1c. The clinical pharmacist in collaboration with the diabetes care team implemented ICSI standards for care of patients with type 2 diabetes. The role of pharmacist in diabetes management team has involved behavioral and educational aspects of patients with type 2 diabetes, self-monitoring of blood glucose, lifestyle changes, and the status of diabetes care and general health. Clinically significant differences were achieved in terms of post-prandial blood glucose (PPBG) levels (7.4 ± 1.7 vs. 10.4 ± 2.0 mmol/L) between intervention and control groups, respectively. Percentage of intervention group that reached target PPBG increased from (12.0 to 54.0 %; p = 0.001). Percentage of intervention group that reached target HBA1c increased from 10.5 to 52.0 %. HBA1c values for intervention group were improved as compared to control group (7.8 ± 1.9 % vs. 9.5 ± 2 %; p = 0.001), respectively. Pharmacist’s interventions yielded increased percentage of intervention group as compared to control group, who achieved comprehensive diabetes clinical outcomes.