Universitas Indonesia Conferences, Asian Federation for Pharmaceutical Sciences (AFPS) 2019

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Pharmacist Intervention Improves Clinical Outcomes of Type 2 Diabetes Mellitus Outpatients in Primary Health Care
Atvinda Prilya Afista

Last modified: 2019-07-18


Aims: The study aims to determine whether pharmacist counseling could improve medication adherence, controlling the level of glycemic control, lipid profile, and blood pressure of T2DM outpatient at the primary health facilities (Puskesmas).

Methods: The study was conducted from January to September 2018 with quasi-experimental design and pre-posttest data analysis. The study sites were Puskesmas Pasar Minggu, Jakarta and two Puskesmas at Palembang, South Sumatera: Dempo and Merdeka. Respondent at Puskesmas Merdeka and Pasar Minggu were intervention group (IG) received counseling and booklets from the pharmacist, while control group (CG) who only received booklet was from Puskesmas Dempo. We developed a standard protocol consisted of three times counseling within 4 months of intervention with booklet. We measured medication adherence using Medication Adherence Questionnaire (MAQ), and Pill Adherence Counting Assessment (PCA), measured fasting blood glucose (FBG), HbA1c, lipid profiles (Total Cholesterol (TC), LDL-c, HDL-c, and triglycerides), and blood pressure.

Results: A total of 131 respondents in IG and in CG who were eligible had been selected and completed the study. After the intervention, a result of measurement showed improved adherence. IG also showed improvement in FBG, HbA1c, and lipid profiles (p<0.05), but not in blood pressure. Based on multivariate analysis,  counseling of pharmacists at the Puskesmas Merdeka Palembang has an effect 107.6 times (95% CI:   20.352-569.573) and 16.3 times (95% CI:   5.143-51.872) on changes in FBG and HbA1c, while at the Puskemas Pasar Minggu physical activity was the most determinant factor in controlling the FBG (14.182 times (95%CI (2.711-74.188)) and DM therapy was the most determinant factor influencing the control HbA1c levels (4.857 times (95%CI (1.430 – 16.497).

Conclusion: Pharmacist counseling with booklet can improve the glycemic levels, lipid profile, and improving medication adherence, significantly.