Study On Effect Of Pharmacy Intervention On Type 2 Diabetes Patients

OBJECTIVE:To evaluate the effect of pharmacy intervention on the medication adherence, incidence of adverse drug events (ADE), patient satisfaction and medication discrepancies of type 2 diabetes in-patients receiving polypharmacy. To evaluate the effect of the pharmaceutical care on the discharged type 2 diabetes patients provided when they were in hospital. To review the effect of the pharmacy intervention on the safety and efficiency of medication for patient.METHODS:To initiate the pharmaceutical pathway of type 2 diabetes, the pharmacy intervention was divided into two phases:the pharmacy intervention for in-patients and the follow-up schemes for the discharged patients. The scheme of clinical pharmacist and the method of pharmacy intervention was regulated, to implement the A to Z pharmaceutical care and education during the different stages of in-patients, thus the standard pharmacy intervention program for the type 2 diabetes was constructed, as the practical template of the pharmaceutical pathway in the nation, as the beneficial and necessary supplement to the clinical pathway. The follow-up pharmaceutical schemes of discharged patients were designed, to evaluate of the safety and efficiency of medication, as the reference of pharmacy intervention for the type 2 diabetes patients in communities.We conducted a randomized control trial.Standardized pharmaceutical care was provided to the type 2 diabetes in-patients. Patients who met the entry conditions were randomly enrolled into either pharmacy intervention group or control group. Primary outcome was the patients' medication adherence, and second outcomes were incidence of ADE, patient satisfaction and medication discrepancies. Through a follow-up 1 month after the patients discharged from the hospital, various targets were investigated such as medication adherence, incidence of ADE, glycosylated hemoglobin, readmission (return visit) rate and patient satisfaction.RESULTS:Compared with control group, medication adherence and the incidence of preventable and all ADE of pharmacy intervention group in-patient was improved significantly (P<0.05), and the patient satisfaction with hospitalization and pharmacy direction were improved dramatically (P<0.01);and the medication discrepancies were decreased remarkably (P<0.001).Compared with the control group, the medication adherence of the discharged pharmaceutical care group was improved significantly (P<0.05).There was no significant difference between the two groups for the incidence of all ADE (P>0.05), and the incidence of preventable ADE of pharmacy intervention group was improved significantly (P<0.05),the medication discrepancies were decreased remarkably (P<0.05).The average concentration of HbA1C was significant difference (P<0.05).Although there was no statistical significance for readmission (return visit) rate between the two groups (P>0.05), the satisfaction of the patients in pharmaceutical care group was improved dramatically (P<0.001).CONCLUSION:The trial initiated the standard service of clinical pharmacist, it constructed the pharmaceutical pathway and the follow-up schemes, which gained the positive remarks of the physicians and patients in clinical treatments. This mode of intervention can also be expanded to the treatments of other chronic diseases. At the same time, it accumulated the experience of medicinal education for different patients.Pharmacy intervention according to the pharmaceutical pathway can improve the medication adherence, patient satisfaction, lower the incidence of ADR and medication discrepancies in the treatment of the type 2 diabetic in-patients. Standardized pharmaceutical care provided for the type 2 diabetic in-patients can improve the patients'satisfaction and medication adherence after they were discharged, and lower the incidence of preventable ADE and the average concentration of HbA1C. However, there was no significant difference for readmission (return visit) rate between two groups.The result of the trail showed that the standardized pharmaceutical service will ensure the safety and efficiency of medication, improve the patients' satisfaction. It is very important to implement the standardized pharmaceutical service for the patients with chronic diseases.