Influence of pharmaceutical care on health outcomes in patients with Type 2 diabetes mellitus
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Bibliographic record
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Pharmaceutical care programmes delivered by pharmacists are known to improve quality of care for both ambulatory and hospitalized patients with a variety of chronic and acute conditions. • Reduction of HbA 1c and normalization of blood pressure are key targets for diabetes care programmes, since they are key to reducing diabetes complications. • Good knowledge about disease, medications, diet and exercise requirements can improve the effectiveness of self‐management of diabetes. WHAT THIS STUDY ADDS • In a randomized, controlled clinical trial, a comprehensive pharmaceutical care programme (consisting of patient education and advice on medication adherence, metabolic control and life style) delivered by a clinical pharmacist over a 12‐month period, significantly improved glycaemic control and health‐related quality of life in Type 2 diabetes patients attending a military hospital outpatient clinic in the United Arab Emirates (UAE). • A significant reduction in HbA 1c was important in the reduction of the 10‐year coronary heart disease risk scores (by British National Formulary and Framingham methods) seen in patients who received the present care programme. • The outcomes of this study advocate an increased role for clinical pharmacists in the healthcare system in the UAE. AIMS To examine the influence of a pharmaceutical care programme on disease control and health‐related quality of life in Type 2 diabetes patients in the United Arab Emirates. METHODS A total of 240 Type 2 diabetes patients were recruited into a randomized, controlled, prospective clinical trial with a 12‐month follow‐up. A range of clinical measures, medication adherence and health‐related quality of life (Short Form 36) were evaluated at baseline and up to 12 months. Intervention group patients received pharmaceutical care from a clinical pharmacist, whereas control group patients received their usual care from medical and nursing staff. The primary outcome measure was change in HbA 1c . British National Formulary and Framingham scoring methods were used to estimate changes in 10‐year coronary heart disease risk scores in all patients. RESULTS A total of 234 patients completed the study. Significant reductions ( P < 0.001) in mean values (baseline vs. 12 months; 95% confidence interval) of HbA 1c [8.5% (8.3, 8.7) vs. 6.9% (6.7, 7.1)], systolic [131.4 mmHg (128.1, 134.7) vs. 127.2 mmHg (124.4, 130.1)] and diastolic blood pressure [85.2 mmHg (83.5, 86.8) vs. 76.3 mmHg (74.9, 77.7)] were observed in the intervention group; no significant changes were noted in the control group. The mean Framingham risk prediction score in the intervention group was 10.56% (9.7, 11.4) at baseline; this decreased to 7.7% (6.9, 8.5) ( P < 0.001) at 12 months but remained unchanged in the control group. CONCLUSIONS The pharmaceutical care programme resulted in better glycaemic control and reduced cardiovascular risk scores in Type 2 diabetes patients over a 12‐month period.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it