The impact of pharmaceutical care on the clinical outcome of diabetes mellitus among a rural patient population

AIM To evaluate the impact of pharmaceutical care on the clinical outcomes of patients enrolled in a pharmacist-coordinated diabetes management program in a rural health setup. SETTINGS AND DESIGN Patients were registered into 'control' and 'intervention' groups by randomization at three primary health centers. The study was an open-label parallel study. MATERIALS AND METHODS Medical records were prospectively reviewed. Capillary blood glucose level, blood pressure and demographic data were collected at baseline and at the follow-up visits. Pharmacists gave counseling to the intervention group during every visit and their health-related quality of life (HRQoL) was assessed with the Ferrans and Powers questionnaire. STATISTICAL ANALYSIS Single factor ANOVA and the t-test were used to compare the results using SPSS version 0.9 software and MS Excel worksheets. RESULTS The intervention group (n = 104) showed well-controlled BMI, whereas the control group (n = 50) showed significant increase in the BMI. Mean blood glucose level in the intervention group reduced to 25 units from baseline (P = 0.0001) but was significantly increased in the control group (P = 0.0001). ANOVA showed that from the second follow-up onward there was significant decrease in blood glucose levels. Overall, the HRQoL scores increased by 45% in the intervention group and decreased by 2% in the control group. CONCLUSIONS The pharmaceutical care program was effective in improving the clinical outcome and HRQoL of diabetes patients in rural India. Such 'pharmaceutical care' models should be fine-tuned and implemented widely.