Impact of pharmacist-involved collaborative care on diabetes management in a primary healthcare setting using real-world data.

Background Diabetes mellitus is a complex multi-system disorder, requiring multi-disciplinary care. The conventional care model, where physicians are the sole caregivers may not be optimal. Addition of other healthcare team members improves healthcare outcomes for patients with diabetes. Aim To evaluate the impact of pharmacist-involved collaborative care on diabetes-related outcomes among patients with diabetes attending a primary healthcare setting  in Qatar using real-world data. Method A retrospective cohort study was conducted among patients with diabetes attending Qatar Petroleum Diabetes Clinic. Patients were categorized as either receiving pharmacist-involved collaborative care (intervention group) or usual care (control group). Data were analyzed using SPSS®. Glycemic control (glycated hemoglobin A1c, HbA1c), blood pressure, lipid profile, and body mass index were evaluated at baseline and up to 17 months of follow-up. Results After 17 months of follow-up, pharmacist-involved collaborative care compared to usual care resulted in a significant decrease in HbA1c (6.8 ± 1.2% vs. 7.1 ± 1.3%, p < 0.01). Moreover, compared to baseline, pharmacist-involved collaborative care significantly improved (p < 0.05) the levels of HbA1c (7.5% vs. 6.8%), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), and body mass index (30.42 kg/m2 vs. 30.17 kg/m2) after 17 months within the intervention group. However, no significant changes for these parameters occurred within the control group. Conclusion The implementation of pharmacist-involved collaborative care in a primary healthcare setting improved several diabetes-related outcomes over 17 months. Future studies should determine the long-term impact of this care model.

Collaborative care model for diabetes in primary care settings in Qatar: a qualitative exploration among healthcare professionals and patients who experienced the service.

BACKGROUND: Diabetes mellitus is highly prevalent and associated with huge economic burden globally. The conventional care and management of diabetes mellitus is highly fragmented and complex, warranting the need for a comprehensive Collaborative Care Model (CCM). Little is known about the perception of patients with diabetes and their healthcare providers about CCM, its barriers and facilitators. This study aimed to explore the value of CCM in diabetes care at a primary healthcare (PHC) setting from the perspective of patients with diabetes and healthcare professionals (HCPs), in an effort to expand our current knowledge on collaborative care in diabetes at primary care level for the purpose of quality improvement and service expansion. METHODS: Using an exploratory case study approach, semi-structured interviews were conducted among patients and HCPs who encountered CCM in Qatar during 2019 and 2020. The semi-structured interviews were transcribed verbatim and the data were analysed and interpreted using a deductive-inductive thematic analysis approach. RESULTS: Twelve patients and 12 HCPs at a diabetes clinic participated in one-to-one interviews. The interviews resulted in five different themes: the process and components of collaborative care model (four subthemes), current organizational support and resources (three subthemes), impact of collaborative care model on diabetes outcomes (three subthemes), enablers of collaborative care model (three subthemes), and barriers to collaborative care model (three subthemes). The participants indicated easy access to and communication with competent and pleasant HCPs. The patients appreciated the extra time spent with HCPs, frequent follow-up visits, and health education, which empowered them to self-manage diabetes. HCPs believed that successful CCM provision relied on their interest and commitment to care for patients with diabetes. Generally, participants identified barriers and facilitators that are related to patients, HCPs, and healthcare system. CONCLUSIONS: The providers and users of CCM had an overall positive perception and appreciation of this model in PHC settings. Barriers to CCM such as undesirable attributes of HCPs and patients, unsupportive hospital system, and high workload must be addressed before implementing the model in other PHC settings.

Impact of a Collaborative Pharmaceutical Care Service Among Patients With Diabetes in an Ambulatory Care Setting in Qatar: A Multiple Time Series Study.

BACKGROUND: Diabetes mellitus is highly prevalent in the Middle East and the burden associated with it is dramatically increasing. Pharmacists working in collaborative healthcare teams have an important role to improve outcomes in the primary care of diabetes. OBJECTIVES: To evaluate the impact of a collaborative pharmaceutical care service (CPCS) on improving outcomes among patients with diabetes in a primary care setting. METHODS: This was a retrospective, multiple time series study involving patients attending an ambulatory diabetes clinic at Qatar Petroleum Healthcare Center in Dukhan, Qatar. Patients' glycated hemoglobin A1c, fasting plasma glucose, body mass index, systolic blood pressure, diastolic blood pressure, and lipid profile were obtained at baseline, 6 months, and 12 months of receiving CPCS through a retrospective chart review. A repeated-measures analysis of variance test was used to determine the impact of the intervention on clinical outcomes. RESULTS: Ninety-six patients with diabetes were included in the analyses. There was a statistically significant reduction (ie, improvement) in glycated hemoglobin A1c by 1.4%, fasting plasma glucose by 41.3 mg/dL, body mass index by 1 kg/m2, systolic blood pressure by 14.9 mm Hg, and diastolic blood pressure by 8.7 mm Hg from baseline to 12 months (P<.001 for all). Nevertheless, no significant reductions were observed in the lipid profile. CONCLUSIONS: CPCS provision improves clinical outcomes in patients with diabetes over a 12-month follow-up period in a primary healthcare setting. Future studies should determine the long-term impact of a collaborative care model in this setting.