Community pharmacist-led educational intervention to recommend ophthalmology visits for patients with diabetes: a cluster randomized controlled trial

抄録

BACKGROUND

It remains unclear whether pharmacist-led educational programs in community pharmacies could increase appropriate ophthalmic visits for patients with diabetes. We assessed efficacy of pharmacist-led education on ophthalmology visits for diabetes.

METHODS

We conducted a cluster randomized controlled trial at 32 community pharmacies in Japan, targeting individuals with diabetes with no ophthalmic visits over a year. Pharmacists in the intervention group received online training on diabetic retinopathy and educated patients, while the control group received a pamphlet. The primary outcome was ophthalmic visits during the follow-up period. Generalized estimating equations were performed with two adjusted models: age and sex (model 1), and additionally diabetic retinopathy factors (model 2). Key secondary outcomes were changes in behavior for ophthalmic visits and glycated hemoglobin (HbA1c) levels.

RESULTS

Overall, 268 patients were included (133 intervention and 135 control). Participants’ mean age was 60.1 years, and HbA1c level was 7.5%. Ophthalmic visits occurred in 18.8% (25/133) of the intervention and 20.7% (28/135) of the control group, yielding no significant difference (model 1, risk difference [RD] −0.03 [−0.14 to 0.08], risk ratio [RR] 0.88 (0.54 to 1.45); model 2, RD −0.07 [−0.21 to 0.08], RR 0.73 [0.41 to 1.30]). There was no significant difference between the two groups in the mean changes from baseline to 6 months in behavior for ophthalmic visits (0.07 [−0.23 to 0.37]) and HbA1c levels (−0.28 [−0.76 to 0.20]).

CONCLUSIONS

Pharmacist-led education on diabetic retinopathy did not increase ophthalmology visits or improve diabetes-related outcomes. Effective strategies to encourage ophthalmology visits are required.