Determining Effective Diabetic Care; A Multicentre - Longitudinal Interventional Study

Background: Prevalence of chronic diseases are on the rise with majority occurring in developing countries where the projected death caused by chronic diseases will reach 50 million by the year 2020. Objective: The aim of the study is to evaluate and compare the outcomes of wireless mobile device (Telemonitoring) with Pharmacist intervention and usual care on glycemic control and clinical outcomes. Method: This study is a six-month parallel groups interventional longitudinal multi-center study with a control arm. The study participants consist of patient diagnosed with type 2 diabetes mellitus and attending the outpatient department (OPD) for diabetic treatment. The study protocol is approved from ministry of health Malaysia and clinical research committee (CRC). Data analysis was made using IBM SPSS Statistics, version 22 (Armok, NY). Results: A total of 150 participants were selected to enroll in this study. Initial baseline comparison showed ‘No significant difference’ between the two intervention arms and control group. Findings showed that baseline dataset have no significant change among all three-arms. However last week of study showed significant (p<0.001) improvement among pharmacist intervention arm as compared to telemonitoring and control arm. Glycemic control seems well tolerated and managed among pharmacist intervention arm as compared to telemonitoring and control arm (p<0.001). The study findings also showed reduction of mean 2.72 % (HbA1c) as compare to baseline in six months. The proportion of participants experiencing hypoglycemic/hyperglycemic events was significantly lower in the pharmacist intervention group compared to telemonitoring and control arm (odds ratio: 2.1381; 95% CI: 3.0267-1.6059, p<0.001). Conclusion: The Pharmacist educational focus-home care program improves the patient knowledge, self-care practices and also significantly reduce the adverse events over study duration.