Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes

Aims: To investigate (i) optimal intensity (four visits vs. six visits) and duration (6 vs. 12 months) of the Diabetes Medication Assistance Service in community pharmacy and (ii) sustainability of improvements in patients’ diabetes control associated with differing intensities of intervention. Meth...

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Main Authors: Krass, I., Mitchell, B., Song, Y., Stewart, K., Peterson, G, Hughes, Jeffery, Smith, L., White, L., Armour, C
Format: Journal Article
Published: Diabetes UK 2011
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/28971
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author Krass, I.
Mitchell, B.
Song, Y.
Stewart, K.
Peterson, G
Hughes, Jeffery
Smith, L.
White, L.
Armour, C
author_facet Krass, I.
Mitchell, B.
Song, Y.
Stewart, K.
Peterson, G
Hughes, Jeffery
Smith, L.
White, L.
Armour, C
author_sort Krass, I.
building Curtin Institutional Repository
collection Online Access
description Aims: To investigate (i) optimal intensity (four visits vs. six visits) and duration (6 vs. 12 months) of the Diabetes Medication Assistance Service in community pharmacy and (ii) sustainability of improvements in patients’ diabetes control associated with differing intensities of intervention. Methods: A national quota sample of 90 community pharmacies in Australia were randomly assigned into group 1 (6-month Diabetes Medication Assistance Service) or group 2 (12-month Diabetes Medication Assistance Service) and subsequently recruited a total of 524 patients. A wide range of clinical (HbA1c, blood pressure, lipids) and quality-of-life outcome measures were assessed.Results: The 6- and 12-month Diabetes Medication Assistance Service resulted in significant and similar reductions in HbA1c (−0.9 mmol/mol; 95% CI −0.7 to −1.1) –, total cholesterol (−0.3 mmol/l; 95% CI −0.1 to −0.4) and triglycerides (−0.3 mmol/l; 95% CI −0.1 to −0.5). There was also a significant reduction in the number of patients who were at risk of having a cardiovascular event in the next 10 years. For the subset of patients for whom data were available at baseline, completion and 18 months, improvements in HbA1c and total cholesterol were sustained at 18 months and triglycerides showed a further improvement at 18 months. Conclusions: The Diabetes Medication Assistance Service resulted in significant improvements in diabetes control that were independent of intensity and duration of the service and showed evidence of being sustained at 18 months. The extent and sustainability of clinical improvements achieved by the Diabetes Medication Assistance Service, together with the resulting reduction in cardiovascular risk, should translate into future cost savings to healthcare systems by delaying and reducing diabetes-related complications.
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spelling curtin-20.500.11937-289712017-09-13T16:07:20Z Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes Krass, I. Mitchell, B. Song, Y. Stewart, K. Peterson, G Hughes, Jeffery Smith, L. White, L. Armour, C self-management support HbA1c Type 2 diabetes community pharmacy cardiovascular risk Aims: To investigate (i) optimal intensity (four visits vs. six visits) and duration (6 vs. 12 months) of the Diabetes Medication Assistance Service in community pharmacy and (ii) sustainability of improvements in patients’ diabetes control associated with differing intensities of intervention. Methods: A national quota sample of 90 community pharmacies in Australia were randomly assigned into group 1 (6-month Diabetes Medication Assistance Service) or group 2 (12-month Diabetes Medication Assistance Service) and subsequently recruited a total of 524 patients. A wide range of clinical (HbA1c, blood pressure, lipids) and quality-of-life outcome measures were assessed.Results: The 6- and 12-month Diabetes Medication Assistance Service resulted in significant and similar reductions in HbA1c (−0.9 mmol/mol; 95% CI −0.7 to −1.1) –, total cholesterol (−0.3 mmol/l; 95% CI −0.1 to −0.4) and triglycerides (−0.3 mmol/l; 95% CI −0.1 to −0.5). There was also a significant reduction in the number of patients who were at risk of having a cardiovascular event in the next 10 years. For the subset of patients for whom data were available at baseline, completion and 18 months, improvements in HbA1c and total cholesterol were sustained at 18 months and triglycerides showed a further improvement at 18 months. Conclusions: The Diabetes Medication Assistance Service resulted in significant improvements in diabetes control that were independent of intensity and duration of the service and showed evidence of being sustained at 18 months. The extent and sustainability of clinical improvements achieved by the Diabetes Medication Assistance Service, together with the resulting reduction in cardiovascular risk, should translate into future cost savings to healthcare systems by delaying and reducing diabetes-related complications. 2011 Journal Article http://hdl.handle.net/20.500.11937/28971 10.1111/j.1464-5491.2011.03296.x Diabetes UK restricted
spellingShingle self-management support
HbA1c
Type 2 diabetes
community pharmacy
cardiovascular risk
Krass, I.
Mitchell, B.
Song, Y.
Stewart, K.
Peterson, G
Hughes, Jeffery
Smith, L.
White, L.
Armour, C
Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes
title Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes
title_full Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes
title_fullStr Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes
title_full_unstemmed Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes
title_short Diabetes Medication Assistance Service Stage 1: impact and sustainability of glycaemic and lipids control in patients with Type 2 diabetes
title_sort diabetes medication assistance service stage 1: impact and sustainability of glycaemic and lipids control in patients with type 2 diabetes
topic self-management support
HbA1c
Type 2 diabetes
community pharmacy
cardiovascular risk
url http://hdl.handle.net/20.500.11937/28971