Effectiveness of Pharmacist-Led Training Regarding Medication for Type 2 Diabetes, Based on Patient and Physician Medication-Related Issues Identified in China

Zhong Hui Yang,1,&ast; Chang Juan Cheng,1 Guo Mei Chen,1 Ji Huang,1,&ast; Hai Zhou,2 Jie Jiang,3 Zhen Ye,4 Yu Fang Weng,5 Hai Hong Tan1 1Department of Pharmacy, Taicang First People’s Hospital, Soochow University, Taicang, Jiangsu, People’s Republic of China; 2Health Service Center of Chengxiang Town, Taicang, Jiangsu, People’s Republic of China; 3Taicang Port District People’s Hospital, Taicang, Jiangsu, People’s Republic of China; 4Huangjing People’s Hospital of Taicang City, Taicang, Jiangsu, People’s Republic of China; 5Taicang Shuangfeng People’s Hospital, Taicang, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chang Juan Cheng, Department of Pharmacy, Taicang First People’s Hospital, Soochow University, No. 58, Changsheng South Road, Taicang City, Jiangsu Province, People’s Republic of China, Tel +86 13915495574, Email [email protected] Guo Mei Chen, Department of Pharmacy, Taicang First People’s Hospital, Soochow University, No. 58, Changsheng South Road, Taicang City, Jiangsu Province, People’s Republic of China, Tel +86 13776297087, Email [email protected]: To determine the effect of pharmacist-led specialized medication training on rational drug prescription by family physicians, and to characterize the drug-related issues and glycemic control of patients.Methods: We performed a study led by clinical pharmacists. Using surveys of medication use by doctors and patients, a 1-year training program was developed to improve the knowledge of family physicians regarding appropriate drug use. It consisted of an initial survey to assess both physician knowledge and patient medication use, followed by a training program designed to address the identified deficiencies. The program comprised quarterly group training sessions focusing on medication updates, guidelines, and clinical case discussions. Cross-sectional sampling was performed before and after doctors’ intervention, carry out a questionnaire survey and compare the questionnaire scores. Patients were randomly sampled before intervention, medication problems were investigated before and after intervention. The effects of the intervention were evaluated by comparing the survey results before and after, with focuses on drug knowledge, rational prescribing, and patient outcomes such as blood glucose control.Results: Before and after the intervention, 120 valid questionnaires were collected from family doctors in each group. Both groups were principally composed of general practitioners with primary titles, but most had 0– 5 years of experience, followed by > 20 years. A total of 361 patients were sampled (174 men; mean age 66.8± 9.62 years), of whom 215 (59.6%) had had type 2 diabetes for 6– 15 years, and 126 (34.9%) had had the disease for ≤ 5 years. After the training, the score had significantly improved, from 32.67± 6.14 to 37.12± 6.24 (P< 0.05), and there were fewer misunderstandings about oral and injectable medications (P< 0.05). The number of patients with medication issues decreased by 55.0% (from 171 to 77, P< 0.05), and their mean fasting plasma glucose concentration (FPG) had also significantly decreased (P< 0.05).Conclusion: The intervention studied improved family physicians’ knowledge of medication for type 2 diabetes, reduced the number of medication issues for patients, and improved their FPG concentrations. It should provide a valuable reference for chronic disease management. This pharmacist-led training approach could be expanded to improve medication practices and patient outcomes on a larger scale, particularly for the purposes of chronic disease management. By including such programs, medication-related issues could be reduced in number and overall treatment effectiveness could be enhanced.Plain Language Summary: What is already known about this subject?The training of family doctors regarding type 2 diabetes focuses on patient education and health guidance. There is a lack of specialized training regarding the use of specific medications.Interventions by pharmacists regarding rational drug use mainly involve prescription reviews and audits, with only limited provision of training for family doctors regarding the use of medication. In addition, there have been few investigations regarding the misconceptions held by both doctors and patients regarding specific medications.What does this study add?This study adds valuable insight into the current gaps in the knowledge of family doctors regarding medication, particularly regarding the treatment of type 2 diabetes. It highlights the need for dedicated training regarding the management of medication use and provides evidence that pharmacist-led interventions can improve understanding and reduce the number of errors made.Keywords: type 2 diabetes mellitus, clinical pharmacist, primary healthcare, chronic disease management, specialized medication training