Impact of clinical pharmacists intervention on management of hyperglycemia in pregnancy in Jordan

Int J Clin Pharm. 2018 Feb;40(1):48-55. doi: 10.1007/s11096-017-0550-3. Epub 2017 Nov 14.

Abstract

Background and objective Hyperglycemia in pregnancy is a risk factor for cardiovascular disease and postpartum (PP) diabetes. This study aimed to assess the impact of the clinical pharmacist-assisted program (CPAP) of optimizing drug therapy and intensive education on main management outcome measures of patient knowledge about diabetes, Quality of life (QoL) as measured by SF-36 including maternal complications, fasting plasma glucose (FPG) control, and HbA1c. Method This is a randomized controlled study. Pregnant (20-28 weeks) patients with hyperglycemia received CPAP (n = 51) as compared with conventional management (n = 34). Patients were then followed up for 6 weeks pp. Results A significant change was shown in the intervention group for diabetes knowledge (3.47% vs. control 2.03%, P < 0.05) and three aspects of health-related QoL. The need for caesarian delivery (58.8% vs. control 35.3%) and severe episodes of hypoglycemia (0% vs. control 8.8%) were significantly (P < 0.05) reduced in the intervention group. Six weeks PP reduction in HbA1c values was greater in the intervention group (- 0.54% vs. control - 0.08%, P = 0.04) with more FPG-controlled patients during pregnancy (94% vs. control 64.7%). Conclusion Clinical pharmacist assisted services in the management of pregnancy hyperglycemia fundamentally and significantly improve knowledge and disease control.

Keywords: Clinical pharmacist; Glycemic control; Jordan; Patient education; Pregnancy hyperglycemia; Quality of life.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / drug therapy*
  • Diabetes, Gestational / epidemiology
  • Disease Management
  • Early Medical Intervention / methods*
  • Early Medical Intervention / trends
  • Female
  • Humans
  • Hyperglycemia / diagnosis
  • Hyperglycemia / drug therapy*
  • Hyperglycemia / epidemiology
  • Hypoglycemic Agents / therapeutic use
  • Jordan / epidemiology
  • Longitudinal Studies
  • Pharmacists* / trends
  • Pregnancy
  • Pregnancy in Diabetics / diagnosis
  • Pregnancy in Diabetics / drug therapy*
  • Pregnancy in Diabetics / epidemiology
  • Professional Role*
  • Prospective Studies

Substances

  • Hypoglycemic Agents