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Title:	The impact of pharmacist led intervention on clinical outcomes, medication adherence and quality of life among type 2 diabetes patients at a tertiary care hospital in Malaysia
Authors:	Mubashra Butt (P60262)
Supervisor:	Adliah Mhd Ali, Dr.
Keywords:	Diabetes mellitus Hospital Tertiary care Dissertations, Academic -- Malaysia
Issue Date:	4-Mar-2016
Description:	Malaysia is situated in the Western Pacific region which bears around 36.17 % of the total diabetes mellitus population. Despite high prevalence of disease in this region there is a lack of reported pharmacist intervention outcomes from this region. Pharmacist intervention has been shown to improve the clinical outcomes among diabetes patients in various parts of the world. The aim of this study was to evaluate the impact of a pharmacist intervention on HbA1c, medication adherence, quality of life and other secondary outcomes among type 2 diabetes patients in Malaysia. An intervention programme (PEPP) was developed after referring to the national and international guidelines combined with the literature review of the existing intervention programmes. After development of the PEPP via expert panel discussions, a patient survey was performed to obtain feedback of the patients regarding the important factors in diabetes education. In the final phase, PEPP was implemented on diabetes patients in a randomised controlled trial. Type 2 diabetes mellitus patients (n = 73) attending endocrine clinic at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were randomised to either the control (n = 36) or the study group (n = 37) after screening. Patients in the study group received an intervention from a pharmacist at the enrolment, after three and six months of the enrolment. Outcome measures such as HbA1c, BMI, lipid profile, Morisky scores and quality of life (QoL) scores were assessed at the enrolment and after 6 months of the study in both groups. Patients in the control group did not undergo intervention or educational module other than the standard care at UKMMC. A total of 66 patients completed the intervention, 33 in control and 33 in the study group. HbA1c values reduced significantly from 9.66 % to 8.47 % (P = 0.001) in the study group. However, no significant changes was noted in the control group (9.64 % to 9.26%, P = 0.14). BMI values showed significant reduction in the study group (29.34 kg/m2 to 28.92 kg/m2; P = 0.03) and lipid profiles were unchanged in both groups. Morisky adherence scores significantly increased from 5.83 to 6.77 (P = 0.02) in the study group; however, no significant changes was observed in the control group (5.95 to 5.98, P = 0.85). QoL profiles produced mixed results. This randomised controlled study provides evidence about favourable impact of a pharmacist intervention programme on HbA1c, medication adherence and QoL scores among type 2 diabetes patients at UKMMC, Malaysia. Currently there is an ongoing pharmacist managed Medication Therapy Adherence Clinic (MTAC) for diabetes patients in Malaysia. Patients in MTAC are required to meet the pharmacist after every one or two months once they are enroled in the programme. Findings of this study showed significant improvement in HbA1c with patient pharmacist meetings being held after three months of the enrolment. Therefore, it may be suggested to eliminate the frequent meetings between patients and pharmacists in MTAC. Eliminating the excess meetings will facilitate more time efficient use of the pharmacists' manpower in MTAC.,Ijazah Sarjana Sains
Pages:	134
Call Number:	WK815.M941i 2016 9
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Pharmacy / Fakulti Farmasi

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