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Impact of a Community Pharmacist-Delivered Information Program on the Follow-up of Type-2 Diabetic Patients: A Cluster Randomized Controlled Study.

Identifieur interne : 000542 ( Main/Exploration ); précédent : 000541; suivant : 000543

Impact of a Community Pharmacist-Delivered Information Program on the Follow-up of Type-2 Diabetic Patients: A Cluster Randomized Controlled Study.

Auteurs : Yves Michiels [Suisse] ; Olivier Bugnon [Suisse] ; Annie Chicoye [France] ; Sylvie Dejager [France] ; Christine Moisan [France] ; François-André Allaert [France] ; Catherine Hunault [France] ; Laura Romengas [France] ; Hubert Méchin [France] ; Bruno Vergès [France]

Source :

RBID : pubmed:31049873

Descripteurs français

English descriptors

Abstract

INTRODUCTION

Low-quality communication between patients and care providers and limited patient knowledge of the disease and the therapy are important factors associated with poor glycemic control in patients with type 2 diabetes. We conducted a multicenter study to determine whether structured and tailored information delivered by pharmacists to type 2 diabetic patients could improve patient treatment adherence, hemoglobin A1c (HbA1c) levels and knowledge about diabetes.

METHODS

One hundred seventy-four pharmacies were randomized to deliver an educational program on diet, drug treatment, disease and complications during three 30-min interviews over a 6-month period, or to provide no intervention, to type 2 diabetic patients treated with oral antidiabetic agents. Medication adherence was assessed by measuring the medication possession ratio and diabetes control by collecting HbA1c values. Levels of patient treatment self-management and disease knowledge were assessed using self-questionnaires.

RESULTS

Three hundred seventy-seven patients were analyzed. The medication possession ratio, already very high at baseline in the intervention (94.8%) and control (92.3%) groups, did not vary significantly after 6 months with no difference between the two groups. Significant decreases in HbA1c were observed in both groups at 6 months (p < 0.001) and 12 months (p < 0.01), with significantly greater changes from baseline in the intervention group than in the control group at 6 months (- 0.5% vs. - 0.2%, p = 0.0047) and 12 months (- 0.6% vs. - 0.2%, p = 0.0057). Patients in the intervention group showed greater improvement in their ability to self-manage treatment (+ 4.86 vs. + 1.58, p = 0.0014) and in the extent of their knowledge about diabetes (+ 0.6 vs. + 0.2, p < 0.01) at 6 months versus baseline compared with the control group.

CONCLUSION

Tailored information provided by the pharmacist to patients with type 2 diabetes did not significantly improve the already high adherence rates, but was associated with a significant decrease in HbA1c and an improvement of patient knowledge about diabetes.

TRIAL REGISTRATION

ISRCTN33776525.

FUNDING

MSD France.


DOI: 10.1007/s12325-019-00957-y
PubMed: 31049873
PubMed Central: PMC6824455


Affiliations:


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Le document en format XML

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<term>Adult (MeSH)</term>
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<term>Adult</term>
<term>Aged</term>
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<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Physician-Patient Relations</term>
<term>Surveys and Questionnaires</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de regroupements</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>INTRODUCTION</b>
</p>
<p>Low-quality communication between patients and care providers and limited patient knowledge of the disease and the therapy are important factors associated with poor glycemic control in patients with type 2 diabetes. We conducted a multicenter study to determine whether structured and tailored information delivered by pharmacists to type 2 diabetic patients could improve patient treatment adherence, hemoglobin A1c (HbA1c) levels and knowledge about diabetes.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>One hundred seventy-four pharmacies were randomized to deliver an educational program on diet, drug treatment, disease and complications during three 30-min interviews over a 6-month period, or to provide no intervention, to type 2 diabetic patients treated with oral antidiabetic agents. Medication adherence was assessed by measuring the medication possession ratio and diabetes control by collecting HbA1c values. Levels of patient treatment self-management and disease knowledge were assessed using self-questionnaires.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Three hundred seventy-seven patients were analyzed. The medication possession ratio, already very high at baseline in the intervention (94.8%) and control (92.3%) groups, did not vary significantly after 6 months with no difference between the two groups. Significant decreases in HbA1c were observed in both groups at 6 months (p < 0.001) and 12 months (p < 0.01), with significantly greater changes from baseline in the intervention group than in the control group at 6 months (- 0.5% vs. - 0.2%, p = 0.0047) and 12 months (- 0.6% vs. - 0.2%, p = 0.0057). Patients in the intervention group showed greater improvement in their ability to self-manage treatment (+ 4.86 vs. + 1.58, p = 0.0014) and in the extent of their knowledge about diabetes (+ 0.6 vs. + 0.2, p < 0.01) at 6 months versus baseline compared with the control group.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>Tailored information provided by the pharmacist to patients with type 2 diabetes did not significantly improve the already high adherence rates, but was associated with a significant decrease in HbA1c and an improvement of patient knowledge about diabetes.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>TRIAL REGISTRATION</b>
</p>
<p>ISRCTN33776525.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>FUNDING</b>
</p>
<p>MSD France.</p>
</div>
</front>
</TEI>
<pubmed>
<MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM">
<PMID Version="1">31049873</PMID>
<DateCompleted>
<Year>2020</Year>
<Month>04</Month>
<Day>30</Day>
</DateCompleted>
<DateRevised>
<Year>2020</Year>
<Month>04</Month>
<Day>30</Day>
</DateRevised>
<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Electronic">1865-8652</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>36</Volume>
<Issue>6</Issue>
<PubDate>
<Year>2019</Year>
<Month>06</Month>
</PubDate>
</JournalIssue>
<Title>Advances in therapy</Title>
<ISOAbbreviation>Adv Ther</ISOAbbreviation>
</Journal>
<ArticleTitle>Impact of a Community Pharmacist-Delivered Information Program on the Follow-up of Type-2 Diabetic Patients: A Cluster Randomized Controlled Study.</ArticleTitle>
<Pagination>
<MedlinePgn>1291-1303</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s12325-019-00957-y</ELocationID>
<Abstract>
<AbstractText Label="INTRODUCTION">Low-quality communication between patients and care providers and limited patient knowledge of the disease and the therapy are important factors associated with poor glycemic control in patients with type 2 diabetes. We conducted a multicenter study to determine whether structured and tailored information delivered by pharmacists to type 2 diabetic patients could improve patient treatment adherence, hemoglobin A1c (HbA1c) levels and knowledge about diabetes.</AbstractText>
<AbstractText Label="METHODS">One hundred seventy-four pharmacies were randomized to deliver an educational program on diet, drug treatment, disease and complications during three 30-min interviews over a 6-month period, or to provide no intervention, to type 2 diabetic patients treated with oral antidiabetic agents. Medication adherence was assessed by measuring the medication possession ratio and diabetes control by collecting HbA1c values. Levels of patient treatment self-management and disease knowledge were assessed using self-questionnaires.</AbstractText>
<AbstractText Label="RESULTS">Three hundred seventy-seven patients were analyzed. The medication possession ratio, already very high at baseline in the intervention (94.8%) and control (92.3%) groups, did not vary significantly after 6 months with no difference between the two groups. Significant decreases in HbA1c were observed in both groups at 6 months (p < 0.001) and 12 months (p < 0.01), with significantly greater changes from baseline in the intervention group than in the control group at 6 months (- 0.5% vs. - 0.2%, p = 0.0047) and 12 months (- 0.6% vs. - 0.2%, p = 0.0057). Patients in the intervention group showed greater improvement in their ability to self-manage treatment (+ 4.86 vs. + 1.58, p = 0.0014) and in the extent of their knowledge about diabetes (+ 0.6 vs. + 0.2, p < 0.01) at 6 months versus baseline compared with the control group.</AbstractText>
<AbstractText Label="CONCLUSION">Tailored information provided by the pharmacist to patients with type 2 diabetes did not significantly improve the already high adherence rates, but was associated with a significant decrease in HbA1c and an improvement of patient knowledge about diabetes.</AbstractText>
<AbstractText Label="TRIAL REGISTRATION">ISRCTN33776525.</AbstractText>
<AbstractText Label="FUNDING">MSD France.</AbstractText>
</Abstract>
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<LastName>Michiels</LastName>
<ForeName>Yves</ForeName>
<Initials>Y</Initials>
<AffiliationInfo>
<Affiliation>Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Lausanne, Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Community Pharmacy, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.</Affiliation>
</AffiliationInfo>
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<LastName>Bugnon</LastName>
<ForeName>Olivier</ForeName>
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<AffiliationInfo>
<Affiliation>Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Lausanne, Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Community Pharmacy, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.</Affiliation>
</AffiliationInfo>
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<Affiliation>Institut d'Études Politiques de Paris, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Dejager</LastName>
<ForeName>Sylvie</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>MSD France, Courbevoie, France.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Moisan</LastName>
<ForeName>Christine</ForeName>
<Initials>C</Initials>
<AffiliationInfo>
<Affiliation>Department of Diabetology, Pitie Salpetrière, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Allaert</LastName>
<ForeName>François-André</ForeName>
<Initials>FA</Initials>
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<Affiliation>Evaluation Chair BSB-Cenbiotech, Dijon, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Hunault</LastName>
<ForeName>Catherine</ForeName>
<Initials>C</Initials>
<AffiliationInfo>
<Affiliation>MSD France, Courbevoie, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Romengas</LastName>
<ForeName>Laura</ForeName>
<Initials>L</Initials>
<AffiliationInfo>
<Affiliation>Observia Group, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Méchin</LastName>
<ForeName>Hubert</ForeName>
<Initials>H</Initials>
<AffiliationInfo>
<Affiliation>Observia Group, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Vergès</LastName>
<ForeName>Bruno</ForeName>
<Initials>B</Initials>
<Identifier Source="ORCID">0000-0001-8957-629X</Identifier>
<AffiliationInfo>
<Affiliation>Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France. bruno.verges@chu-dijon.fr.</Affiliation>
</AffiliationInfo>
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<Year>2019</Year>
<Month>05</Month>
<Day>02</Day>
</ArticleDate>
</Article>
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<Country>United States</Country>
<MedlineTA>Adv Ther</MedlineTA>
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<RegistryNumber>0</RegistryNumber>
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</Chemical>
</ChemicalList>
<CitationSubset>T</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016000" MajorTopicYN="N">Cluster Analysis</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D003924" MajorTopicYN="N">Diabetes Mellitus, Type 2</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006943" MajorTopicYN="N">Hyperglycemia</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007004" MajorTopicYN="N">Hypoglycemic Agents</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D055118" MajorTopicYN="N">Medication Adherence</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D010353" MajorTopicYN="N">Patient Education as Topic</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D010595" MajorTopicYN="N">Pharmacists</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
<MeshHeading>
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</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="Y">Disease knowledge</Keyword>
<Keyword MajorTopicYN="Y">Glucose control</Keyword>
<Keyword MajorTopicYN="Y">Patient information</Keyword>
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