New research published in Diabetes Research and Clinical Practice demonstrates even greater evidence of what pharmacists already recognize: Including community pharmacists in a collaborative interdisciplinary care team not only improves blood glucose control, but also—and equally importantly—improves the self-care capabilities and quality of life of patients diagnosed with diabetes challenged with polypharmacy.

Coauthor Joyce Yu-Chia Lee, clinical professor of health sciences with the University of California in Irvine, California, and colleagues set out to evaluate both the humanistic and clinical outcomes of a collaborative care model that involved partnership with a community pharmacist.

The authors conducted this study in response to what they describe as a rising global burden of chronic disease in the community, which is only complicated further by individualized needs of the patients challenged by disease burden. The authors write, "Diabetes, a major public health concern, is one of such chronic non-communicable disease that requires frequent monitoring and active lifestyle engagements."

The researchers conducted a multisite, open-label, parallel arm, randomized, controlled trial for just over 6 months in a population that included patients with type 2 diabetes who were prescribed five or more medications (with HbA1c > 7.0%.) A total of 264 participants were randomized to one of the two groups: either physician-centric care (control = 133) or a collaborative-care model (intervention n = 131). The intervention group received telephone follow-up to visits to family physicians, nurses, and dietitians as well as medication therapy management. Changes in HbA1c, systolic blood pressure (SBP), lipids, and hypoglycemic events were counted as clinical outcomes, and humanistic outcomes included changes to quality of life and self-care capabilities.

The authors reported a significantly greater reduction in HbA1c observed in the intervention group (intervention: -0.32% [-3.52 mmol/mol] vs. control: -0.06% [-0.66 mmol/mol], P = .038). The remaining measurements of SBP, lipids, and hypoglycemic events were not significant between groups when measured over 6 months. Humanistic outcomes, however, were significantly greater with improvements observed in both quality of life (P = .003) and self-management (P <.001) within the intervention group.

"Diabetes is a significant public health concern, and many people suffer from more than one such chronic disease, such as hypertension," stated Dr. Lee. "The results of our evaluation of the clinical and humanistic outcomes of a community pharmacist-involved collaborative care model in diabetes management show that this model can narrow communication gaps between patients and their primary care team and form a safety net for individuals with chronic disease."

The authors wrote, "Partnering retail community pharmacists with patient's primary care team improved glycemic control, self-care capabilities and quality of life. The multidisciplinary collaborative care model can form a safety net for community-dwelling individuals with chronic diseases."

Funding for this study was provided by a grant awarded by the National Medical Research Council Health Services.

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