A STUDY ON IMPACT OF CLINICAL PHARMACIST PROVIDED EDUCATION IN PATIENTS WITH TYPE II DIABETES MELLITUS AT A TERTIARY CARE HOSPITAL

Abstract

Background: Type II Diabetes Mellitus (T2DM) is a Chronic disorder often complicated by poor knowledge, low adherence ,and uncontrolled glycemia. Clinical pharmacists play a crucial role in educating and counseling patients to improve long-term outcomes. Aim: Study on impact of clinical pharmacist provided education in patients with type 2 diabetes mellitus at a tertiary care hospital. Objective: To assess the impact of pharmacist- provided education on knowledge, self care activities and health related quality of life and glycemic control in T2DMpatients at a tertiary care hospital. Methodology:  A prospective observational study was conducted over 9 months among 305 T2DM patients. Structured Educational interventions focused on pharmacotherapy, lifestyle modification, and Self-monitoring. Pre and Post –intervention outcomes included HbA1c, FBS and PPBS, Medication Adherence and knowledge scores. Results : In a total of 305 patients,167(54.8%) were males and 138 (45.2%) were Females. A total of 227 patients (74.5%) achieved controlled glycemic levels following pharmacist interventions, whereas 78 (25.5%) remained uncontrolled despite therapy adjustments, emphasizing the importance of continuous follow-up and lifestyle modification.Drug utilization analysis revealed that 58.2% of patients were treated with monotherapy, 31.9% with combinations therapy , and 9.9% with Fixed Dose therapy. Among monotherapies, the most commonly prescribed drug was Gliclazide (14.4%), followed by Glimepiride (13.5%) and Metformin (12.05%), highlighting the predominance of sulfonylureas and biguanides as first-line agents.Most commonly prescribed insulin was Human Mixtard (19.3%).The mean HbA1c value,significant improvements in glycemic control were observed following clinical pharacist  interventions. The main  HbAlc level decreased from 8.6% at baseline to 7.0% at 9months, with an overall percentage reduction of approximately 19.4%which reflecting  long-term glycemic control management. Similarly, Fasting blood sugar (FBS) lvels dropped from an average of 193.4mg/dL to 169.2mg/dL, Showing a mean percentage reduction of  8.13%. Postprandial blood sugar (PPBS) levels also improved significantly, reducting from 201.8mg/dL to 169.1mg/dL, indicating an average reduction of 4.24% over the study period. These findings clearly demostrated the positve impact of continuous pharmacist councelling, regular follow- up and patient education on glycemic  outcomes.  A total of 18 adverse drug reactions (ADRs) were identified.