Authors (including presenting author) :
YAU KM(1), LAM KW (2), WONG KT (2), LEUNG YYJ (3), CHEN J (1), YICK PK (1)
Affiliation :
(1) Department of Pharmacy, Ruttonjee Hospital (2) Department of Pharmacology and Pharmacy, the University of Hong Kong (3) Department of Medicine and Geriatrics, Ruttonjee Hospital
Introduction :
Overseas studies have shown pharmacist-led clinic services, when added to standard of care, could aid attainment of treatment goals and improve therapeutic outcomes. Pharmacist clinic service is an evolving healthcare concept in Hong Kong.
Objectives :
To evaluate diabetes-related outcomes (HbA1c, clinic SBP, and complication screening frequency) in a patient group managed by pharmacists in a pharmacist clinic service, as compared to a comparator group managed with usual care.
Methodology :
This was a service evaluation of a pharmacist clinic in the specialist outpatient department of Ruttonjee Hospital from August 2018 to January 2022. The primary outcomes were changes in HbA1c and clinic systolic pressure at 6 months. Secondary outcomes was the difference in the proportion of patients with urinary albumin-to-creatinine ratio measurement within 12 months. Drug-related problems identified and interventions implemented during the study were recorded. A satisfaction survey was completed by all endocrinologists and diabetes nurses in the hospital.
Result & Outcome :
276 patients met the inclusion criteria. Of these, 144 patients were in the intervention group and 132 patients were in the comparator group. Patients in the intervention group achieved significant HbA1c reduction (–0.55% vs. –0.02%, p<0.001). The difference between the intervention group and the comparator group regarding clinic systolic blood pressure was non-significant (–3.74 vs. –1.37 mmHg, p=0.192). Proportions of patients with urinary albumin-to-creatinine ratio measurement within one year increased from 62.5% to 89.5% (p<0.0001). Pharmacists identified 107 drug-related problems. 58 recommendations were made. Of which, 57 (98.3%) were accepted by physicians. All endocrinologists and nurses agree that they are satisfied with the service and would recommend the service to other specialties and hospitals. In conclusion, a pharmacist clinic service in a public hospital brought about substantial clinical intervention, and was associated with favourable diabetes-related outcomes, including improved glycaemic control and increased complication screening frequency, when added to usual care.
