Impact of a Community Pharmacy-Based Information Program on Type 2 Diabetic Patients’ Adherence: Iphodia, a Cluster Randomized Study VS Usual Practice - 12 Month Final Results

• Published in: Value in health Vol. 20; no. 9; p. A483
• Main Authors: Michiels, Y, Bugnon, O, Chicoye, A, Verges, B, Moisan, C, Mechin, H, Allaert, F
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.10.2017
• Subjects: Access; Adherence; Autoimmune diseases; Clinical trials; Community pharmacists; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Drug delivery; Drugs; Experts; Intervention; Obesity; Pharmacists; Pharmacy; Type 2 diabetes mellitus
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.476

OBJECTIVES: Despite significant improvements in the follow up of type 2 diabetes patients, Entred's latest results showed an insufficient level-of-control with 41% of patients with HbAlc over 7%. Pharmacists could play a beneficial role in patient adherence given their expertise and accessibility. The IPhODia study aims to assess the impact on adherence when community pharmacists provide specific information to patients. METHODS: The intervention consists in three different 30-minute-long interviews over a period of 6 months. TV/o groups of pharmacists have been randomized; one group providing patient interviews in addition to the usual drug delivery, the other group delivering drugs in the usual setting. Criteria of evaluation are the Medication Possession Ratio (MPR) and HbAlc level. RESULTS: In total, 182 pharmacists (91+91) recruited 553 patients (296+257). Patients' main characteristics are similar in both groups (mean age 66;58%male; 45%obese and about lOyears mean diabetes duration). Primary analysis was performed on 377 patients. MPR at baseline was very high and does not change at 6 or 12 months. Mean HbAlc levels significantly decreased after 6 months in the group of patients interviewed by pharmacists (n=160, Baseline 7.9% - 6 months 7.4%) versus the group that didn't have a pharmacy interview (n=162, Baseline 7.7% - 6 months 7.5%). (-0.5% - -0.2 %,(p=0.0035)). At 12 month, HbAlc levels continue to decrease in the group of patients interviewed by pharmacists (n=123, Baseline 7.9% -12 months 7.3%) versus the group without pharmacy interview (n=151, Baseline 7.8% -12 months 7.5%). (-0.6% - -0.2%,(p=0.0057).These results highlight the permanence of the intervention 6 months after it stops. CONCLUSIONS: 12 months results show the persistence of the intervention as HbAlc levels continue to decrease significantly in the group with pharmacist interviews. In total, after a period of one year, 0.6% of HbA1c reduction from baseline has been achieved in the intervention group.