Pharmacist-Led Self-management Interventions to Prevent Diabetic Outcomes: A systematic Review

Abstract

Introduction: Managing diabetes necessitates a rigorous treatment regimen entailing patient-driven self-care. Pharmacists occupy a favorable position to offer essential self-care support. This review delves into whether interventions led by pharmacists to foster self-management in diabetic patients yield favorable clinical and patient-reported outcomes.

Methods: In accordance with PRISMA guidelines, this review followed an extensive literature search. The search encompassed terms like "pharmacist," "diabetes," and "self-management," across databases such as PubMed, Embase, and the Cochrane Library spanning from the database's inception to August 2022. Reference lists of systematic reviews and incorporated studies were also explored. Inclusion criteria encompassed interventions tested through randomized controlled trials (RCTs) centered around self-management, conducted in ambulatory care settings, led by pharmacists, and reporting at least one clinical or patient-reported outcome. Primary outcomes encompassed HbA1c as a long-term diabetes follow-up parameter, self-management, and intervention components. Secondary outcomes included blood glucose, blood pressure, BMI, lipids, medication adherence, quality of life, and diabetes knowledge.

Results: A total of 22  studies, including more than 3,000 patients, were incorporated. Pharmacist-led self-management interventions encompassed education on diabetes complications, medication, lifestyle, and instilling self-management skills. Several studies adopted a tailored approach based on patient requirements. The interventions led by pharmacists exhibited a positive impact on HbA1c levels, yielding a significant average reduction of 0.71%. Additionally, these interventions displayed favorable effects on blood pressure, , lipid profiles and quality of life.

Conclusions:  Pharmacist-led interventions focused on self-management exhibit a notable positive impact on HbA1c levels among individuals with diabetes. This outcome underscores the heightened contribution of pharmacists in patient-centered healthcare. The implication drawn from these findings advocates for pharmacists to actively provide self-management assistance to individuals with diabetes, aiming to enhance overall diabetes-related outcomes.