(197) Evaluation of a Community Pharmacy-Based Diabetes Care: Patients Self-Reported Outcomes Using Validated Questionnaires and Clinical Outcomes

Publication Number: 871

Background: People living with diabetes have vital roles in self-managing their condition. Most studies on personalised care for people with diabetes were conducted in high-income countries. An evidence-informed Community Pharmacy-Based Diabetes Care Plan was developed to provide patient-led goal-setting support and motivational interviewing to people living with type 2 diabetes. Community pharmacists identified what patients perceived as 'problems' with managing their diabetes and supported them in achieving their self-set goals.

Objectives: To evaluate the effects of the care plan on self-reported outcomes using validated questionnaires: patient activation measure (PAM©), quality of life (EQ-5D-5L© and EQ-VAS), medication adherence (Morisky, Green, and Levine Adherence Scale (MGL)); and on clinical outcomes: plasma glucose, waist circumference and body mass index (BMI).

Methods: A longitudinal study design was employed. Ethical approval was obtained before commencing the study. Patients living with type 2 diabetes attended six remote pharmacist consultations over six months in 20 community pharmacies in Lagos, Nigeria. Self-reported outcome measures were collected at baseline and on study completion. Clinical outcomes were collected monthly, including patients' plasma glucose, weight, waist circumference and height. Quantitative data were analysed in STATA V. 14

Results: Of 104 recruited patients, 89 (86%) had complete data for analysis. There were significant improvements (p < 0.05) across all outcome measures from baseline to study end. PAM activation improved for all levels, with 26 (29%) of patients 'highly activated' (level 4) at baseline vs. 37 (42%) at study completion, p-value for McNemar's test was < 0.05. Mean EQ-VAS score was 76 at baseline and 83 on study completion (paired t-test p< 0.001). Adherence assessment improved (p-value < 0.001), with 22 (25%) patients having 'high adherence' at baseline vs. 45 (51%) at the study end. At study completion, participants achieved improved clinical outcomes compared with baseline, shown by statistically significant reductions in BMI, waist circumference, and fasting plasma glucose p < 0.05

Conclusions: The study supports the importance of personalised care to improve people's empowerment to set goals and the outcome measures for their diabetes and wider health. The findings can inform a larger trial.