Pharmaceutical care program for type 2 diabetes patients in Brazil: a randomised controlled trial

• Published in: International journal of clinical pharmacy 2013-02, Vol.35 (1), p.79-86
• Main Authors: Mourão, Aline Oliveira Magalhães, Ferreira, Wandiclécia Rodrigues, Martins, Maria Auxiliadora Parreiras, Reis, Adriano Max Moreira, Carrillo, Maria Ruth Gaede, Guimarães, Andrea Grabe, Ev, Lisiane Silveira
• Format: Article
• Language: English
• Subjects: Aged; Brazil; Clinical trials; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Drug therapy; Female; Glycated Hemoglobin A - analysis; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Pharmaceutical Services; Pharmacists; Pharmacy; Primary care; Research Article
• ISSN: 2210-7703; 2210-7711
• DOI: 10.1007/s11096-012-9710-7

Background Brazilians with type 2 diabetes require action to improve haemoglobin A1C levels considering the fact that approximately 73 % of them have poor glycaemic control. Evidence has shown the potential benefits of pharmaceutical care programs in type 2 diabetes patients. Objective To evaluate the effect of a pharmaceutical care program on blood glucose, blood pressure and lipid profile in hyperglycaemic patients undergoing drug treatment for type 2 diabetes. Setting Six primary care units of the Brazilian public health system, Ouro Preto, Brazil. Method An open, randomised, controlled clinical trial was conducted for 6 months. Subjects aged 18 years or older who were using oral antidiabetic medications and presenting haemoglobin A1C levels ≥7 % were randomly assigned to receive only usual health care or usual health care plus pharmaceutical intervention. Main outcome measure Haemoglobin A1C. Results A total of 129 subjects were enrolled, and 100 patients completed the study. Compared to the control group (n = 50), the intervention group (n = 50) showed a significant reduction of haemoglobin A1C (−0.6 vs 0.7 %, p  = 0.001), fasting plasma glucose, total cholesterol, LDL cholesterol, triglycerides and systolic blood pressure and a significant increase in HDL cholesterol and the use of lipid-modifying agents and platelet aggregation inhibitors. Conclusions This study suggests that a pharmaceutical care program may provide important contributions to reduce haemoglobin A1C in type 2 diabetes patients. Moreover, the promotion of the rational use of drugs may be better achieved in a context of pharmaceutical care programs in Brazil.