Effectiveness the pharmaceutical care in diabetic patients*
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Methods: We carried out pharmacotherapeutical intervention during 19 months on patients with type-2 diabetes mellitus who were affiliate members of the contributive regime of the General System for Healthcare and Social Security in Bogotá and Cartagena. Through an interview and evaluation of medical records, we obtained information about antidiabetic medications used, doses, other medications, along with Hemoglobin A1c level, arterial pressure, serum low-density lipoprotein cholesterol level, nephropathy screening, retinal screening, foot exams in the last year and problems associated with medication use by means of the DADER method Negative Outcomes Associated with Medication (NOM).
Results: The study had a sample of 143 patients (64 intervened and 79 controls) with female predominance (67.1% and 53.1%, respectively), mean age of 63.9±11.2 years. The patients in both groups were taking an average of 6.0±2.7 medications. Initial HbA1c mean was 7.7% and 7.8%, without improvement by the end of the study (7.4% for those intervened and 7.8% for the control group). Hypertension (81.1%) and dyslipidemia (62.9%) were the most important comorbidities. About 50.4% of NOM were of effectiveness, follows 31.3% of necessity. The mean cost per patient in controls was 1.4 greater than for the intervened group.
Conclusions: Increased effectiveness of the antidiabetic therapy was not demonstrated in patients intervened with pharmacotherapeutical monitoring, but we did obtain a reduction in healthcare costs.
- Diabetes mellitus
- Hemoglobina Aglucosilada
- Agentes hipoglucémicos
- Servicios farmacéuticos
- Colombia
Pan American Health Organization (PAHO). Diabetes in theAmericas. Epidemiol Bull. 2001; 22:1-3.2.European Molecular Biology Organization (EMBO). Like asnake in the grass. As the incidence of type 2 diabetesescalates, new developments offer hope for better treatments,reports. EMBO. 2004; 5: 555-8.3.Asociación Latinoamericana de Diabetes. Guías ALAD dediagnóstico, control y tratamiento de la diabetes mellitus tipo2. Rev Asoc Latinoam Diabetes. 2006; 14: 111-6.4.Aschner P, King H, Triana de Torrado M, Rodríguez BM.Glucose intolerance in Colombia. A population-based surveyin an urban community. Diabetes Care. 1993; 16: 90-3.5.Aschner P. Diabetes trends in Latin America. Diabetes MetabRes Rev. 2002; 18: s27-31.6.Oliva J, Lobo F, Molina B, Monereo S. Direct health care costsof diabetic patients in Spain. Diabetes Care. 2004; 27: 2616-21.7.López BJ, Serrano AP, Duque GB. Los costes socioeconómicosde la diabetes mellitus. Aten Primaria. 2002; 29: 145-50.8.Hepler C, Strand L. Opportunities and responsabilities in thePharmaceutical Care. Am J Hosp Pharm. 1990; 47: 533-43.9.Sabater D, Silva M, Faus M. Guía de seguimiento farmaco-terapéutico: Método Dader, grupo de investigación en aten-ción farmacéutica. 3a ed. Granada: Universidad de Granada;2007.10. Comité de Consenso. Tercer Consenso de Granada sobreproblemas relacionados con los medicamentos y resultadosnegativos asociados a la medicación (RNM). [en línea]. ArsPharm 2007: 48: 5-17. URL disponible en: http://farmacia.ugr.es/ars/pdf/374.pdf11. Baena I. Problemas relacionados con los medicamentos comocausa de consulta en el Servicio de Urgencias del HospitalUniversitario Virgen de las Nieves de Granada. Tesis docto-ral. Madrid: Ergo SA; 2004.12. Silva M, Calleja M, Tuneo L, Fuentes B, Gutiérrrez M, FausM. Seguimiento del tratamiento farmacológico en pacientesingresados en un servicio de cirugía. Farm Hosp. 2004; 28:154-69.13. Beney J, Bero LA, Bond C. Expanding the roles of outpatientpharmacists: effects on health services utilisation, costs, andpatient outcomes. Cochrane Database Syst Rev. 2000;CD000336. Review. Update in: Cochrane Database Syst Rev.2010;7:CD000336.14. Agudelo N, Cifuentes J, Amariles P. Impacto de la interven-ción del químico farmacéutico en el proceso de atenciónambulatoria en una institución de salud en Medellín-Colom-bia. Pharm Care Esp. 2003; 5: 1-12.15. Qaseem A, Vijan S, Snow V, Cross T, Weiss K, Owens D.Glycemic control and type 2 diabetes mellitus: the optimalhemoglobin A1c targets. A guidance statement from theAmerican College of Physicians. Ann Intern Med. 2007; 147:417-22.16. Grant RW, Buse JB, Meigs JB, University HealthSystemConsortium (UHC) Diabetes Benchmarking Project Team.Quality of diabetes care in US academic medical centers: lowrates of medical regimen change. Diabetes Care. 2005; 28:337-442.17. Liebl A, Mata M, Eschwège E, ODE-2 Advisory Board.Evaluation of risk factors for development of complications inType II diabetes in Europe. Diabetologia. 2002; 45: S23-8.18. Resnick HE, Foster GL, Bardsley J, Ratner RE. Achievementof American Diabetes Association clinical practicerecommendations among US adults with diabetes, 1999-2002: The National Health and Nutrition Examination Survey.Diabetes Care. 2006; 29: 531-7.19. Lebovitz HE. Oral antidiabetic agents: 2004. Med Clin NorthAm. 2004; 88: 847-63.20. Machado-Alba JE, Moncada-Escobar JC, Gaviria H. Qualityand effectiveness of diabetes care for a group of patients inColombia. Rev Panam Salud Publica. 2009; 26: 529-35.21. González P, Faure E, Del Castillo A, Grupo de Trabajo parael Estudio del Coste de la Diabetes. Cost of diabetes mellitusin Spain. Med Clin (Barc). 2006; 127: 776-84
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