Long-term effect of pharmacist-led interventions on diabetes distress

Abstract

Introduction

The authors previously determined that pharmacist-led educational interventions significantly reduced diabetes distress, hemoglobin A1C (A1C), weight, and Patient Health Questionnaire-2 (PHQ-2) scores among people with type 2 diabetes in a pharmacist-run community care clinic. The objective of this study was to evaluate the long-term effects on diabetes distress and clinical outcomes 1 year after the completion of the educational interventions.

Methods

In this single-center interventional study, participants with type 2 diabetes who completed the original diabetes distress study were recruited for a 1-year post-intervention assessment. In the original study, participants qualified for pharmacist-led educational interventions based on the Association of Diabetes Care and Education Specialists (ADCES)7 Self-Care Behaviors™ depending on Diabetes Distress Scale (DDS) scores. Diabetes distress, A1C, weight, and PHQ-2 were evaluated at 1 year post-intervention and compared with baseline values. Participant satisfaction was also evaluated. Data analysis included descriptive statistics and paired t-tests.

Results

Of the 45 participants who completed the original study, 31 (68.9%) consented to participate in the 1-year post-intervention assessment. Mean DDS score decreased from 2.2 at baseline to 1.6 at 1-year post-intervention (p = 0.004). Significant reductions in emotional burden, regimen distress, and physician distress were observed from baseline to 1-year post-intervention (p = 0.001, p = 0.004, and p = 0.016, respectively). Reductions in overall DDS, emotional burden, regimen distress, and physician distress were both statistically and clinically significant, as they exceeded the minimal clinically important differences. Changes in A1C, weight, and PHQ-2 scores were not significant at 1-year post-intervention; however, most participants were achieving A1C treatment goals, and the presence of depression was low. Participants remained highly satisfied with the service, their knowledge, and self-management skills at 1-year post-intervention.

Conclusion

Improvements in diabetes distress were maintained 1 year after the completion of pharmacist-led educational interventions. This study supports a role for pharmacists in screening for diabetes distress and the sustainable impact of tailored diabetes education.