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Efficacy of Pharmacist Based Diabetes Educational Interventions on Clinical Outcomes of Adults With Type 2 Diabetes Mellitus: A Network Meta-Analysis

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Author(s)
Allah Bukhsh
Allah Bukhsh
Tahir M. Khan
Tahir M. Khan
Tahir M. Khan
Shaun W. H. Lee
Learn-Han Lee
Learn-Han Lee
Learn-Han Lee
Learn-Han Lee
Learn-Han Lee
Kok-Gan Chan
Kok-Gan Chan
Bey-Hing Goh
Bey-Hing Goh
Bey-Hing Goh
Bey-Hing Goh
Bey-Hing Goh
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Keywords
diabetes education
glycosylated hemoglobin
type 2 diabetes mellitus
pharmaceutical care
meta-analysis
Therapeutics. Pharmacology
RM1-950

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URI
http://hdl.handle.net/20.500.12424/2382773
Online Access
https://doaj.org/article/f4765bc23a5c4bcaa1a68b88237d3ccd
Abstract
Background: Comparative efficacy of different pharmacist based interventions on glycemic control of type 2 diabetes patients is unclear. This review aimed to evaluate and compare the efficacy of different pharmacist based interventions on clinical outcomes of type 2 diabetes patients.Methods: A systematic search was conducted across five databases from date of database inception to September 2017. All randomized clinical trials evaluating the efficacy of pharmacist based interventions on type 2 diabetes patients were included for network meta-analysis (NMA). The protocol is available with PROSPERO (CRD42017078854).Results: A total of 43 studies, involving 6259 type 2 diabetes patients, were included. NMA demonstrated that all interventions significantly lowered glycosylated hemoglobin (HbA1c) levels compared to usual care, but there was no statistical evidence from this study that one intervention was significantly better than the other for reducing HbA1c levels. Pharmacist based diabetes education plus pharmaceutical care showed maximum efficacy for reducing HbA1c levels [−0.86, 95% CI −0.983, −0.727; p < 0.001]. Pharmacist based diabetes education plus pharmaceutical care was observed to be statistically significant in lowering levels of systolic blood pressure [−4.94; 95%CI −8.65, −1.23] and triglycerides levels [−0.26, 95%CI −0.51, −0.01], as compared to the interventions which involved diabetes education by pharmacist, and for body mass index (BMI) [−0.57; 95%CI −1.25, −0.12] in comparison to diabetes education by health care team involving pharmacist as member.Conclusion: The findings of this review demonstrate that all interventions had a significantly positive effect on HbA1c, but there was no statistical evidence from this study that one intervention was significantly better than the other for achieving glycemic control.Pharmacist based diabetes education plus pharmaceutical care showed maximum efficacy on HbA1c and rest of the clinical outcomes.
Date
2018-04-01
Type
Article
Identifier
oai:doaj.org/article:f4765bc23a5c4bcaa1a68b88237d3ccd
1663-9812
10.3389/fphar.2018.00339
https://doaj.org/article/f4765bc23a5c4bcaa1a68b88237d3ccd
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