The impact of pharmaceutical care on improving outcomes in patients with type 2 diabetes mellitus from China: a pre- and postintervention study
Objective To evaluate the effectiveness of pharmaceutical care services in management teams by assessing the change in hemoglobin A1c (A1C), cholesterol, and blood pressure for patients with type 2 diabetes in a diabetes ward. Setting Tongde hospital of Zhejiang province, a 1,200 bed South China teaching hospital, serving the local community. Method A single-center, 2-phase (pre-/postintervention phase) designs was performed. Patients in postintervention phase (July 2013 to December 2013) received pharmaceutical care from a clinical pharmacist, while patients in the preintervention phase (January 2013 to June 2013) received routine medical care. The pre- and postintervention phases were then compared to evaluate the outcomes of pharmaceutical care services. Main outcome measure The primary end point was the absolute change in A1C versus baseline, the change in cholesterol and blood pressure and the number of patients to achieve Chinese Diabetes Society (CDS) goals at the baseline and at the end of pharmaceutical care were the main outcome measures. Results During the 6-month study period, the postintervention phase showed a greater percent change in A1C (−1.45 vs. −0.43 %, P = 0.03). Another end points for achieving CDS goals were statistically significantly different in low-density lipoprotein, triglycerides and blood pressure. In the phase that received the participation of pharmacists, the number of patients that improved in A1C increased from 327 to 406 (P = 0.02); the number of rehospitalization was 29 for the postintervention phase and 75 for the preintervention phase (P = 0.05).The drug cost per patient day decreased from € 254.74 to € 219.85 (P = 0.095), and the Length of stay (LOS) did not change significantly (16.35 vs. 15.91 days; P = 0.15).Conclusion Including a pharmacist as a part of the diabetes management team may result in lower A1C, cholesterol and blood pressure in patients versus a health care.