THE IMPACT OF HOME MEDICATION REVIEW IN PATIENTS WITH TYPE 2 DIABETES MELLITUS LIVING IN RURAL AREAS OF KUANTAN, MALAYSIA
Author(s)
Nor Elina A1, Che Suraya MZ1, Ball PA2
1International Islamic University Malaysia, Kuantan, Pahang, Malaysia, 2Charles Darwin University, Darwin, Australia
OBJECTIVES: To investigate whether Home Medication Review (HMR) conducted by a pharmacist can improve the clinical indices, quality of life and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM). METHODS: Six month prospective, randomized, controlled study. Adult T2DM patients taking medications for diabetes for at least two years, with HbA1c>8%, were recruited into the study and randomized to intervention or control. The intervention group received three home visits by a pharmacist (at baseline, 3 months and at 6 months), and one group counselling session with a dietician in addition to the standard medical care. Control group patients only received standard medical care. Primary outcome measures were HbA1c and fasting blood sugar (FBS). Secondary outcome measures include lipid profile (triglycerides, LDL- and HDL-cholesterol); blood pressure (BP); medication adherence (assessed using modified Morisky adherence scale); and quality of life (QoL) assessed using the Short form health survey (SF-36v2). Outcomes were evaluated at baseline, 3 months and at 6 months. RESULTS: from baseline to 6 months in the intervention group in; HbA1c (mean difference (MD) = 1.57, 95% CI[0.88, 2.26], p<0.001); FBS (MD=2.76, 95% CI[0.59,4.94], p=0.009); systolicBP (MD=6.56, 95% CI[0.75,12.36], p=0.022); diastolicBP (MD=4.44, 95% CI[1.11,7.78], p=0.006); triglycerides (MD=0.59, p<0.001) and medication adherence (MD=-2.19, p<0.001). The control group showed no significant changes in outcome measures. QoL improved in the intervention group but declined in controls. CONCLUSIONS: In this study, HMR conducted by a pharmacist provided significant improvement in health and QoL of patients with Type 2 Diabetes Mellitus. HMR may be beneficial for patients with chronic diseases and for the healthcare system.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PHS11
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Diabetes/Endocrine/Metabolic Disorders