Incidence of stroke with uncontrolled DM: Effect of pharmaceutical care intervention to DM type-2 patients in Iraqi hospitals

Abstract

Diabetes is a chronic disease that is associated with high morbidity and mortality from its complications The aim of this study was to describe the role of the pharmacist as a health care provider and the implementation of a pharmaceutical care model to improve blood sugar level, lipid profile, medications adherence and knowledge in a sample of Iraqi patients suffering from DM and evaluate the incidence of stroke with uncontrolled DM patient. A total of 70 patients, whether their blood sugar was controlled or not, were enrolled in the study and randomly classified into either control group (CG) or intervention group (IG); both received the usual hospital care and kept on their antihypertensive. Patients in the IG, beside the usual hospital care, received a pharmaceutical care program described in the methods. All patients visited the clinic monthly up to three months for check and evaluation. Significant improvements were observed in the studied parameters for the IG compared with the CG, at the end of the study, although there was no significant difference (P > 0.05) between them in demographics and characteristics at the baseline. evaluated the studied parameters at the baseline and at the end of the study for both groups. For control group regarding FBG, HbA1C,TG and cholestrol at baseline and the end of study results revealed non-significant difference in each of FBG(P=0.497), HbA1C (P= 0.11), TG (p=0.177) and cholesterol (p=0.36) . While in response to the pharmaceutical care intervention, results at the end of the study for the intervention group, compared with the base line, revealed a statistically significant reduction (P < 0.05) in all FBG, HbA1C, TG and cholesterol.Regarding medications adherence findings showed that 10 of 35 patients (28.57%) had low adherence, 19 of 35 patients (54.29%) had intermediate adherence and 6 of35patients (17.14%) had high adherence for control group at baseline and that not be changed at the end of the study .Respecting the intervention group was at a baseline 13 of 35 patients (37.14%) had low adherence,15 of 35 (42.86%) had intermediate adherence and 7 of 35(20%) had high adherence,at the end of study results highly improved, that 2 only of 35 patient (5.17%) had low adherence,6 of 35 patients(17.14%)had intermediate adherence and all 27 of 35 patients(77.14%) had high adherence Also for control group the result revealed that the patient which developed to have a stroke increased to 8 of 35 patients (22.8) after was 4of 35 patient (11.42).respecting that in intervention group that the patients had stroke was 5 of 35 patients (14.28%) at a baseline and in the end of the study developed to 7of 35 patients (20%) with a stroke.At the end of study the patients knowledge for control group not significant improved (p=0.638) while there was a significant improved (p= <0.001) for intervention group. Conclusion: Pharmacist intervention can significantly improve Blood sugar level, lipid profile, medication adherence and patients’ knowledge.