A Multifactorial
Intervention to Enhance Adherence to Medications and
Disease-Related Knowledge in Type 2 Diabetic Patients in
Southern Punjab, Pakistan
Abdul Majeed Samtia1*,
Muhammad Fawad Rasool1, Nazar
Muhammad Ranjha1, Faisal Usman1
and Ibrahim Javed1
1Faculty of Pharmacy,
Bahauddin Zakaryia University, Multan, Pakistan
*For correspondence:
Email:
abdulmajeedsamtia@yahoo.com,
Tel: +923336139819
Received:
23 August 2012
Revised accepted:
17 June 2013
Tropical Journal of
Pharmaceutical Research, October 2013;
12(5):
851-856
http://dx.doi.org/10.4314/tjpr.v12i5.28
Abstract
Purpose:
To assess the impact of
pharmacist-led multifactorial interventions on health
parameters, medication adherence, and disease-related
knowledge among type 2 diabetic patients in southern
Punjab, Pakistan.
Methods: The effect of intervention
was evaluated by randomly assigning patients into
control group (n = 170), receiving conventional medical
care, and intervention group (n = 178), receiving
predefined specialized care. The primary outcome of this
intervention study was improvement in glycemic control
which was assessed by measuring fasting blood glucose
and glycosylated haemoglobin (HbA1c) values.
Results:
The outcomes obtained
clearly show the role of pharmacist counseling in the
control of type 2 diabetes while improving fasting blood
glucose (FBG) and HbA1c levels, reduction in Body Mass
Index (BMI), improvement in disease knowledge as well as
reduction in smoking. The intervention
significantly reduced BMI and waist circumference by a
difference of 1.87 (p = 0.014) and 1.27 (p = 0.002)
between control and intervention groups. Glycemic
control was significant within the intervention group,
as evident by a reduction in fasting blood glucose level
{-19.26 mg/dL (p = 0.003)} and HbA1c level {-1.01 % (p <
0.001)} compared to control group. The mean difference
in glycemic control between both groups was
insignificant but mild reductions were seen in fasting
blood glucose (-11.95 mg/dL, p = 0.11) and HbA1c (-0.43
%, p = 0.12). A significant increase in disease-related
knowledge was seen in the intervention group, compared
to the control group which was evident by mean
differences in compliance (p = 0.003), foot-care (p <
0.001) and self-monitoring of blood glucose (p = 0.001).
Conclusion:
The purpose of study was
achieved in that it demonstrates that pharmacists can
play a pivotal role in improving glycemic control in
diabetic patients and that involvement of pharmacists in
diabetic clinics is beneficial to the patients in terms
of medication adherence and promotion of healthy
lifestyle.
Keywords: Diabetes, Intervention,
Medication adherence, Glycemic control, BMI, HbA1c
