Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial
© 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd Background: Reviewing pharmacist diabetes intervention studies revealed a lack of structured process in providing diabetes care, leading to varied results from increased to minimal impr...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Published: |
John Wiley and Sons Inc.
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/72382 |
| _version_ | 1848762735050883072 |
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| author | Ayadurai, S. Sunderland, Bruce Tee, L. Md Said, S. Hattingh, H. |
| author_facet | Ayadurai, S. Sunderland, Bruce Tee, L. Md Said, S. Hattingh, H. |
| author_sort | Ayadurai, S. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd Background: Reviewing pharmacist diabetes intervention studies revealed a lack of structured process in providing diabetes care, leading to varied results from increased to minimal improvements. The aim of this study was to determine the effectiveness of the Simpler tool, a structured clinical guidelines tool, in the delivery of diabetes care. The primary outcome was significant improvement in HbA1c. Secondary outcomes were improved lipid profiles and blood pressure (BP). Methods: A 6-month parallel multicenter two-arm, single-blind randomized controlled trial involving 14 pharmacists at seven primary care clinics was conducted in Johor, Malaysia. Pharmacists without prior specialized diabetes training were trained to use the tool. Patients were randomized within each center to either Simpler care (SC), receiving care from pharmacists who used the tool (n =55), or usual care (UC), receiving usual care and dispensing services (n = 69). Results: Compared with UC, SC significantly reduced HbA1c (mean reduction 1.59% [95% confidence interval {CI} -2.2, -0.9] vs 0.25% [95% CI -0.62, 0.11], respectively; P = 0.001), and significantly improved systolic BP (-6.28 mmHg [95% CI -10.5, 2.0] vs 0.26 mmHg [95% CI -3.74, 0.43], respectively; P = 0.005). A significantly higher proportion of patients in the SC than UC arm reached the Malaysian guideline treatment goals for HbA1c (14.3% vs 1.5%; P = 0.020), systolic BP (80% vs 42%; P = 0.001), and low-density lipoprotein cholesterol (60.5% vs 40.4%; P = 0.046). Conclusions: Using the Simpler tool facilitated the delivery of comprehensive evidence-based diabetes management and significantly improved clinical outcomes. The Simpler tool supported pharmacists in providing enhanced structured diabetes care. |
| first_indexed | 2025-11-14T10:52:17Z |
| format | Journal Article |
| id | curtin-20.500.11937-72382 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:52:17Z |
| publishDate | 2018 |
| publisher | John Wiley and Sons Inc. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-723822018-12-13T09:34:21Z Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial Ayadurai, S. Sunderland, Bruce Tee, L. Md Said, S. Hattingh, H. © 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd Background: Reviewing pharmacist diabetes intervention studies revealed a lack of structured process in providing diabetes care, leading to varied results from increased to minimal improvements. The aim of this study was to determine the effectiveness of the Simpler tool, a structured clinical guidelines tool, in the delivery of diabetes care. The primary outcome was significant improvement in HbA1c. Secondary outcomes were improved lipid profiles and blood pressure (BP). Methods: A 6-month parallel multicenter two-arm, single-blind randomized controlled trial involving 14 pharmacists at seven primary care clinics was conducted in Johor, Malaysia. Pharmacists without prior specialized diabetes training were trained to use the tool. Patients were randomized within each center to either Simpler care (SC), receiving care from pharmacists who used the tool (n =55), or usual care (UC), receiving usual care and dispensing services (n = 69). Results: Compared with UC, SC significantly reduced HbA1c (mean reduction 1.59% [95% confidence interval {CI} -2.2, -0.9] vs 0.25% [95% CI -0.62, 0.11], respectively; P = 0.001), and significantly improved systolic BP (-6.28 mmHg [95% CI -10.5, 2.0] vs 0.26 mmHg [95% CI -3.74, 0.43], respectively; P = 0.005). A significantly higher proportion of patients in the SC than UC arm reached the Malaysian guideline treatment goals for HbA1c (14.3% vs 1.5%; P = 0.020), systolic BP (80% vs 42%; P = 0.001), and low-density lipoprotein cholesterol (60.5% vs 40.4%; P = 0.046). Conclusions: Using the Simpler tool facilitated the delivery of comprehensive evidence-based diabetes management and significantly improved clinical outcomes. The Simpler tool supported pharmacists in providing enhanced structured diabetes care. 2018 Journal Article http://hdl.handle.net/20.500.11937/72382 10.1111/1753-0407.12799 John Wiley and Sons Inc. restricted |
| spellingShingle | Ayadurai, S. Sunderland, Bruce Tee, L. Md Said, S. Hattingh, H. Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial |
| title | Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial |
| title_full | Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial |
| title_fullStr | Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial |
| title_full_unstemmed | Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial |
| title_short | Structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: A randomized controlled trial |
| title_sort | structured tool to improve clinical outcomes of type 2 diabetes mellitus patients: a randomized controlled trial |
| url | http://hdl.handle.net/20.500.11937/72382 |