Implementation of Pharmaceutical Care to Improve Therapeutic Outcomes and Quality of Life in Type 2 Diabetes Mellitus Patients at Batubara Public Health Center

Citra Syahriani Damanik; Khairunnisa Khairunnisa; Wiryanto Wiryanto

doi:10.35451/bym4fr96

Authors

Citra Syahriani Damanik Program Studi Magister Ilmu Farmasi, Fakultas Farmasi, Universitas Sumatera Utara
Khairunnisa Khairunnisa Departemen Farmakologi dan Farmasi Klinis/Komunitas, Fakultas Farmasi, Universitas Sumatera Utara
Wiryanto Wiryanto Departemen Farmakologi dan Farmasi Klinis/Komunitas, Fakultas Farmasi, Universitas Sumatera Utara

DOI:

https://doi.org/10.35451/bym4fr96

Keywords:

Pharmaceutical Care, Type 2 Diabetes Mellitus, Outcomes Therapy

Abstract

Background: Pharmacists have a significant function in delivering pharmaceutical care services aimed at maximizing therapeutic success for individuals with type 2 diabetes mellitus. Objective: The objective of this research was to evaluate the impact of pharmaceutical care practices on medication adherence, therapeutic outcomes, quality of life, and the frequency of drug-related problems (DRPs) in patients diagnosed with type 2 diabetes mellitus at Batubara community health centers. Methods: This research employed a comparative experimental approach with a prospective cohort design, assessing 66 participants across three community health centers during a three-month period before and after the intervention. Medication adherence was measured using the MARS-5 questionnaire, while DRPs were identified with the PCNE V9.1 instrument. Therapeutic outcomes were determined from random blood glucose (RBG) and HbA1c levels, and the Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ) was used to assess quality of life. Data analysis was conducted using the Wilcoxon Signed Rank Test and Friedman Test via SPSS version 22.0. Results: The mean medication adherence score improved substantially from 5.21±0.90 to 23.39±1.78 following pharmaceutical care intervention. The average number of DRPs per patient declined from 1.26±0.44 to 0.12±0.48. Moreover, mean RBG levels decreased from 305.79±82.86 mg/dl to 194.62±67.67 mg/dl, and HbA1c levels reduced from 9.37±1.52% to 8.69±1.48%. The mean quality of life score also showed an increase from 7.20±0.90 to 11.14±0.77. Conclusion: The provision of structured pharmaceutical care significantly improved medication adherence, optimized therapeutic outcomes, minimized drug-related problems, and enhanced the overall quality of life of type 2 DM patients in Batubara community health centers.

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References

[1] N. A. ElSayed et al., “Summary of Revisions: Standards of Care in Diabetes-2024,” Diabetes Care, vol. 47, no. 1, pp. S5–S10, Jan. 2024, doi: 10.2337/dc24-SREV.

[2] W. Hening, R. D. Sartika, and R. Sauriasari, “Effect of hospital pharmacist counseling on clinical outcomes of type 2 diabetes mellitus outpatients,” J. Res. Pharm. Pract., vol. 8, no. 3, p. 155, 2019, doi: 10.4103/jrpp.JRPP_19_67.

[3] M. R. Masdin, R. A. D. Sartika, and R. Sauriasari, “Evaluation of pharmacist-led structured counselling on glycemic control and clinical outcomes of Type 2 diabetes mellitus patients at a health centre in East Jakarta, Indonesia,” Pharm. Educ., vol. 22, no. 2, pp. 194–199, Mar. 2022, doi: 10.46542/pe.2022.222.194199.

[4] P. Saeedi et al., “Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition,” Diabetes Res. Clin. Pract., vol. 157, p. 107843, Nov. 2019, doi: 10.1016/j.diabres.2019.107843.

[5] B. Presley, W. Groot, E. Setiawan, and M. Pavlova, “Perspectives of pharmacists and patients on pharmacist services to improve medication adherence among patients with diabetes in Indonesia,” J. Pharm. Heal. Serv. Res., vol. 14, no. 2, pp. 167–177, Jun. 2023, doi: 10.1093/jphsr/rmad025.

[6] H. Sun et al., “IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045,” Diabetes Res. Clin. Pract., vol. 183, p. 109119, Jan. 2022, doi: 10.1016/j.diabres.2021.109119.

[7] Fajriansyah, A. Iskandarsyah, I. M. Puspitasari, and K. Lestari, “Impact of pharmacist counseling on health-related quality of life of patients with type 2 diabetes mellitus: a cluster randomized controlled study,” J. Diabetes Metab. Disord., vol. 19, no. 2, pp. 675–682, Dec. 2020, doi: 10.1007/s40200-020-00528-x.

[8] H. Rina, A. Nasution, and Khairunisa, “Impact of pharmacist counseling on the clinical outcomes in the management of type 2 diabetes mellitus outpatients admitted to a hospital,” Int. J. Basic Clin. Pharmacol., vol. 13, no. 1, pp. 42–46, Dec. 2023, doi: 10.18203/2319-2003.ijbcp20233818.

[9] D. F. Mechessa and B. Kebede, “Drug-Related Problems and Their Predictors Among Patients with Diabetes Attending the Ambulatory Clinic of Gebre Tsadik Shawo General Hospital, Southwest Ethiopia,” Diabetes, Metab. Syndr. Obes. Targets Ther., vol. Volume 13, pp. 3349–3357, Sep. 2020, doi: 10.2147/DMSO.S267790.

[10] N. Prihartini, Y. Yuniar, A. L. Susyanty, and R. Raharni, “Kepuasan Pasien Rawat Jalan terhadap Pelayanan Kefarmasian di Rumah Sakit dan Puskesmas di 11 Provinsi di Indonesia,” J. Kefarmasian Indones., pp. 42–49, Feb. 2020, doi: 10.22435/jki.v10i1.1697.

[11] E. T. Arsita Setyani, D. Anggraini, R. A. Aulia, and A. W. Mukti, “Artikel Review : Peranan Apoteker Dalam Pelayanan Kefarmasian Pada Pasien Diabetes Melitus (DM),” Farm. J. Sains Farm., vol. 4, no. 2, pp. 93–106, 2023, doi: 10.36456/farmasis.v4i2.7614.

[12] Y. Mayasari, P. Sarnianto, and Y. Anggriani, “Pengaruh Asuhan Kefarmasian Terhadap Kualitas Hidup Pasien Diabetes Melitus Tipe 2 di Dua Puskesmas Daerah Jakarta Timur,” Syntax Lit. ; J. Ilm. Indones., vol. 5, no. 6, p. 221, Jun. 2020, doi: 10.36418/syntax-literate.v5i6.1338.

[13] C. C. Serdar, M. Cihan, D. Yücel, and M. A. Serdar, “Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies,” Biochem. medica, vol. 31, no. 1, pp. 27–53, Feb. 2021, doi: 10.11613/BM.2021.010502.

[14] L. Ratna Tuladhar, S. Lal Shrestha, S. Bimali, S. Bhusal, and P. Khadka, “Drug-drug Interactions between Hypoglycemic and Non-hypoglycemic Medication in Diabetic Patients with Comorbidities in a Tertiary Care Center: A Descriptive Cross-sectional Study,” J. Nepal Med. Assoc., vol. 59, no. 243, pp. 1125–1130, Nov. 2021, doi: 10.31729/jnma.7080.

[15] A. Firdiawan, T. M. Andayani, and S. A. Kristina, “Hubungan Kepatuhan Pengobatan Terhadap Outcome Klinik Pasien Diabetes Melitus Tipe 2 dengan Medication Adherence Rating Scale-5 (MARS-5),” Maj. Farm., vol. 17, no. 1, p. 22, 2021, doi: 10.22146/farmaseutik.v17i1.48053.

[16] A. Rahmawaty and P. H. Hidayah, “Hubungan Drug Related Problems (DRPs) Kategori Interaksi Obat pada Penggunaan Obat Pasien Diabetes Mellitus Tipe 2,” Cendekia J. Pharm., vol. 4, no. 1, pp. 80–88, May 2020, doi: 10.31596/cjp.v4i1.76.

[17] S. Marupuru, A. Roether, A. J. Guimond, C. Stanley, T. Pesqueira, and D. R. Axon, “A Systematic Review of Clinical Outcomes from Pharmacist Provided Medication Therapy Management (MTM) among Patients with Diabetes, Hypertension, or Dyslipidemia,” Healthcare, vol. 10, no. 7, p. 1207, Jun. 2022, doi: 10.3390/healthcare10071207.

[18] R. Tampa’i, J. Sumombo, H. Hariyadi, and Y. Lengkey, “Gambaran Drug Related Problems (DRPs) pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Tuminting,” J. Kefarmasian Indones., pp. 49–55, Feb. 2021, doi: 10.22435/jki.v11i1.3499.

[19] D. Purwantiningsih, N. M. Yasin, and S. A. Kristina, “Pengaruh Medication Therapy Management Terhadap Kepatuhan, Outcome Klinik dan Kualitas Hidup Pasien Diabetes Mellitus,” Maj. Farm., vol. 17, no. 3, Sep. 2021, doi: 10.22146/farmaseutik.v1i1.62497.