Impact of Pharmacist Interventions on Health Outcomes of Patients with Type 2 Diabetes Mellitus in the Middle East: A Systematic Review.

Abstract

This systematic review aimed to evaluate the association between pharmacists' interventions and health outcomes of patients with type 2 Diabetes Mellitus (DM) in the Middle East. A comprehensive database search was conducted in July 2024 using the electronic databases of PubMed, MEDLINE, Embase, Cochrane Library, Web of Science and Scopus. The search strategy involved the following keywords: "Impact", "Effect", "Pharmacist", "Pharmacy services", "Pharmaceutical Care", "Intervention", "Type 2 diabetes mellitus", "diabetes", and "Middle East". Articles published in the English language between January 2010 and July 2024 related to the research question were included. The data extracted from the included papers were summarized using narrative data synthesis. Twelve articles were selected from 536 retrieved articles, with most studies conducted in hospitals (n = 10) and randomized clinical trials (n = 8). The quality of studies was evaluated using the Cochrane risk of bias tool for RCTs and the Newcastle-Ottawa Scale for non-randomized studies to ensure transparent evaluation of the study quality. Narrative synthesis was employed to address variations in study design, outcomes, and biases. Pharmacist interventions reported included patient education (n = 11), counseling (n = 5), drug therapy initiation (n = 5), and dosage adjustment (n = 5). Studies reported significant reductions in glycosylated (HbA1c) (range: 1.4-1.78%) and fasting blood glucose levels (FBG) (range: 2.3-53 mg/dL), decreased systolic and diastolic blood pressure (range: 4.65-14.9 mmHg), body mass index (BMI) (range: 1-2.44 kg/m2), cholesterol, triglycerides, and total cholesterol, and improved medication adherence, self-care activities, and knowledge of diabetes management. In this review, pharmacist interventions reported were associated with improved clinical and humanistic outcomes among type 2 DM patients in the Middle-East. Therefore, collaborative care models involving pharmacists and other healthcare practitioners in the management of type 2 DM should be considered by health policymakers in the region.