Impact of clinical pharmacist-led diabetes management clinic on health outcomes at an academic hospital in Riyadh, Saudi Arabia: A prospective cohort study.

backgroundDiabetes prevalence is estimated to reach 20.6% by 2030. Studies have illustrated main reasons for uncontrolled patients and concluded: low level of awareness, limited access to healthcare providers, and lack of cooperation between different disciplines. The role of pharmacists has been proven to improve patient-related outcomes, including an improvement in HgA1C readings between 0.54% and 1.6%.

objectivesThis study was conducted to evaluate diabetes-related health outcomes in a pharmacist-led diabetes clinic in terms of HgbA1C level, guideline-recommended routine screenings, medication adherence, and biomarkers of other comorbidities.

methodA prospective cohort study conducted from August 2017 until July 2018 at an academic hospital. The pharmacist-led diabetes clinic was providing the service for a half-day per week. The study included all adult diabetic patients referred to the pharmacist-led clinic and had -at least- three 3-month apart follow-up visits with no exclusions. The baseline assessments for patients receiving routine diabetic care was performed using HgbA1C level, blood pressure, lipid and thyroid panel, eye and foot examinations, preventive measures, and adherence. The baseline results were compared to the follow-up results thereafter. A descriptive analysis was used to report the differences between intervals. Main outcome measure: (a) Reduction in HgbA1c levels, (b) intervention made by clinical pharmacists in an outpatient setting.

resultThe study included thirty-five patients. The mean ± SD age was 56 ± 10 years old. At baseline, mean HgbA1C was 9.5% ± 1.3%. HgbA1C was ≥10% for 13 patients. Albuminuria was never previously assessed for 14 patients. Twenty percent were receiving incorrect dose compared to the guideline-recommended statin therapy. By the end of study, mean HgbA1C had significantly improved to be 8.3% ± 1.4% (p = 0.0004). Nine patients achieved their HgbA1C goal of <7%. All patients were assessed for albuminuria, and managed accordingly. Thirty-two patients were eligible to receive statin therapy, and prescribed appropriate doses. Additionally, peripheral neuropathy was assessed for all cohort, and seven patients received recommended vaccinations.

conclusionInvolving clinical pharmacists in diabetes management clinic can provide valuable services, help patients to adhere to the therapeutic plans, and assist physicians to achieve better treatment outcomes.