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Diabetes and endocrinology
Research
Supporting the management of type 2 diabetes with pharmacist-led reviews: an observational analysis
  1. Tim Langran1,
  2. Nithya Nanda1,
  3. Attia Bataveljic2,
  4. Javier Gonzalez-Durio2
  1. 1NHS Slough CCG, King Edward VII Hospital, Windsor, UK
  2. 2Interface Clinical Services Ltd, Leeds, UK
  1. Correspondence to Dr Tim Langran; tim.langran{at}nhs.net

Abstract

Objective Describe and assess the impact of a pharmacist-led patient review programme on the management and control of type 2 diabetes (T2D).

Design Uncontrolled prospective cohort study with before and after intervention data collection.

Setting General practices within NHS Slough Clinical Commissioning Group (CCG).

Participants 5910 patients with T2D.

Interventions Pharmacists reviewed 5910 patients and worked with general practice teams to schedule any of the 9 key care processes recommended by the National Institute for Health and Care Excellence (NICE) that the patients were lacking, to optimise medication and to make other interventions such as providing lifestyle advice.

Main outcome measures The proportion of patients receiving the NICE-recommended 9 key care processes and proportion of patients whose glycated haemoglobin (HbA1c), blood pressure (BP) or total cholesterol (TC) readings were over target before and after the intervention period.

Results The proportion of patients receiving all of the NICE-recommended 9 key care processes increased from 46% at project outset in April 2013 to 58% on completion in April 2014 and the percentage of patients achieving HbA1c, BP and TC targets all increased (65% to 70%, 70% to 76%, 78% to 82%, respectively). Quality Outcomes Framework (QOF) data for Slough CCG showed the percentage of diabetic patients achieving target HbA1c, BP and TC readings increased from April 2013 to April 2014, but then diminished in the year after project completion.

Conclusions The pharmacist-led review increased the number of key care processes administered and improved diabetic control during the year of programme delivery. The improvement abated during the year after, suggesting that such programmes should be ongoing rather than fixed term. The programme combined the strategic drive and project facilitation skills of Slough CCG, the general practice teams' knowledge of their patients and the clinical and information technology skills of an experienced pharmacist team.

  • diabetes
  • pharmacist
  • PRIMARY CARE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-013451

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    Footnotes

    • Contributors As the guarantor, TL conceived the study. AB and JG-D managed the data collection and presentation, while TL and NN monitored the conduct of the study and provided clinical interpretation and analysis of the results.

    • Funding It was conducted as an observational analysis of a pharmacist-led clinic programme which was funded by NHS Slough CCG and delivered in partnership with Interface Clinical Services, an independent clinical services provider.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.