Abstract

Objective: Pharmacists have not demonstrated the ability to manage chronic diseases such as Type 2 Diabetes Mellitus, which is an ongoing problem in Trinidad and Tobago. The primary objective was to demonstrate that pharmacists can assist patients to achieve at least a 1% decrease in glycosylated haemoglobin (HbA1c ).

Methods: A randomized, controlled Pharmacist Evaluative Research Study compared the efficacy of pharmacist-managed care (the intervention), and routine standard management (control) of poorly controlled (abnormal HbA1c , blood pressure, blood glucose and lipid panel) adult diabetic patients. Participants in the intervention group met with the pharmacist at their respective primary care sites on a regular basis for an assessment of adherence to medications, barriers to adherence and education. Control group participants consisted of patients receiving routine care by their primary physician but with no direct intervention by the pharmacist except for the filling of prescriptions.

Results: Seventy-five patients were initially recruited. Of these, 48 (20 intervention and 28 control) met the inclusion criteria. It was only possible to analyse the result from 20 patients: 14 (70%) intervention and 6 (21.4%) control because of incomplete collected data. A minimum decrease of at least 1% HbA1c was obtained by 8 (57%) intervention participants compared to 2 (33%) in the control group; while HbA1c remained unchanged for two participants, each in the intervention and control groups (14% and 33%, respectively).

Conclusion: We could not conclude any statistical or clinical significance in the paper as the data could only be analysed using descriptive methods. Building a culture of research among pharmacists may promote the use of pharmacists as adjunctive healthcare practitioners to achieve better patient outcomes.