Pharmaceutical care – impact on quality of life in patients with type 2 diabetes: a review

Abstract

Type 2 diabetes mellitus (T2DM), a chronic disorder now reaching epidemic proportions, imposes a huge burden on individuals and health care systems. In recent years, pharmacists, highly trained health care professionals with expertise in medicines, have sought to develop an expanded role in diabetes care. Evidence suggests that pharmaceutical care produces improvements in glycemic control; however, little is known about its impact on humanistic outcomes such as health-related quality of life (HRQoL). This review aimed to address this gap. A systematic search was conducted of English language articles published from 1996 to January, 2013 in Cochrane databases of systematic reviews and clinical trials, CINAHL, Embase, MEDLINE, PubMed, International Pharmaceutical Abstracts, PsycINFO, and Web of Science databases to identify relevant original research articles and reviews linking pharmaceutical care, T2DM, and HRQoL. The quality of selected articles was assessed using a modified version of the Downs and Black checklist. Of a total of 122 articles addressing pharmaceutical care in T2DM, 17 articles were suitable for inclusion: 12 studies used generic HRQoL instruments, six used diabetes-specific HRQoL scales, and one study used both. Because of the different scales used and the level of detail, it is difficult to compare between studies. The results provide some preliminary evidence that pharmaceutical care in T2DM can have a positive impact on HRQoL, with the evidence pointing to a greater effect on mental rather than physical health; however, these findings are inconclusive. The mean quality score for the 13 studies included in the quality rating was 0.63 ± 0.11 (range 0.40–0.76), which is classified as only fair. Future studies should use robust research designs to bolster the evidence for the impact of pharmaceutical care on HRQoL using both generic and disease-specific measures.