Search

The number of patients with diabetes is expected to increase by 51% worldwide within the next 25 years, with diabetes complications resulting in high health costs (1). Consequently, comprehensive diabetes care is essential to control disease progression. Pharmacists are able to contribute to diabetes care in different settings (2,3). However, large randomized controlled trials for community pharmacists are rare. Therefore, GLICEMIA 2.0 was developed to examine whether intensive pharmacist-delivered care in community pharmacies can effectively improve glycemic control and reduce risk for complications. GLICEMIA 2.0 was a multicenter, cluster-randomized controlled trial in 26 German pharmacies randomly assigned to the control or intervention group. Pharmacists from each center were trained prior to the start of the trial for 1 day regarding how to conduct the study. Pharmacists of the intervention group received an additional day of training that included medication analysis and counseling of behavioral changes. The Freiburg Ethics Commission International, Freiburg, Germany, approved the trial (016/1826). Eligible participants had type 2 diabetes, BMI of at least 25 kg/m2, and HbA1c ≥7% (53 mmol/mol). Data were collected at baseline and after 6 and 12 months. The assessment included HbA1c (point of care; Abbott Afinion AS 100 Analyzer), fasting blood glucose, weight, and blood pressure. Pharmacists supported the participants of the intervention group for 1 year in a protocol-defined lifestyle change …

Aufgrund weltweit steigender Erkrankungszahlen kommt der Pravention des Typ-2-Diabetes eine besondere Bedeutung zu. Trotz zahlreicher Studien hierzu existiert bislang kein flachendeckendes Praventionsprogramm. Aufbauend auf Leitlinienempfehlungen wurde daher das Praventionsprogramm GLICEMIA entwickelt. Ziel der vorliegenden Arbeit war dessen Evaluation mit Schwerpunkt auf dem Risikoerfassungsinstrument FINDRISK. Das Programm umfasst 8 Einheiten innerhalb 1 Jahr (3 individuelle Beratungen, 5 Gruppenschulungen) und wurde in Apotheken umgesetzt. Die Evaluation erfolgte im Rahmen einer Cluster-randomisierten kontrollierten Interventionsstudie. Die Kontrollgruppe stellten Personen dar, welche eine schriftliche Standardinformation erhielten und deren Parameter zu 3 Zeitpunkten erhoben wurden. Insgesamt konnten die Daten von 1092 Probanden, welche in 40 Apotheken teilnahmen, analysiert werden. Durch die Teilnahme an GLICEMIA konnte die Interventionsgruppe ihr Diabetesrisiko gemas FINDRISK-Gesamtpunktzahl im Vergleich zur Kontrollgruppe statistisch signifikant reduzieren (adjustierte Effektgrose: −0,74 Punkte; 95 %–Konfidenzintervall: −1,04 bis −0,42 Punkte). Dies war auf Verbesserungen bei den beeinflussbaren Risikofaktoren Taillenumfang, Bewegung, ballaststoffreiche Ernahrung und Body-Mass-Index zuruckzufuhren. Mit der Evaluation des Praventionsprogramms GLICEMIA wurde erstmals eine gros angelegte Diabetespraventionsstudie in offentlichen Apotheken umgesetzt. Hierbei konnte eine signifikante Reduktion des Diabetesrisikos gemas FINDRISK-Gesamtpunktzahl festgestellt werden. Trotz der Limitation, dass es sich hierbei um ein Selbstberichtsverfahren handelt, erwies sich der Fragebogen fur die niedrigschwellige Umsetzung der Diabetespravention als geeignetes Instrument. Register klinischer Studien: Deutsches Register Klinischer Studien DRKS00006585

With its increasing incidence, diabetes is one of the major challenges of the 21th century. Against this background, the Bavarian State Ministry of Public Health and Care Services (BStMGP) started in 2014 the campaign "Diabetes moves us!". The scientific institute for prevention in health care (WIPIG) supported the activities of Bavarian pharmacies and evaluated the extent to which they might be able to contribute towards prevention. Besides additional training of pharmaceutical staff, WIPIG initiated a diabetes prevention network. Pharmacies that were members of the network had the opportunity to order a campaign package including an evaluation questionnaire and to register their activity in the calendar of events of the campaign. A total of 215 pharmacies signed up for the diabetes prevention network and registered 103 events. The WIPIG received 67 completed evaluation questionnaires. Most often (86.6%) the pharmacies conducted a blood glucose screening; 76.1% carried out screening with the diabetes risk questionnaire FINDRISC of the German Diabetes Foundation and 22.4% gave a information lecture on diabetes. During the screening 2,502 persons had their blood sugar checked and 1,765 persons filled in the FINDRISC questionnaire. Overall, 190 persons were advised to visit their physician because of a very high blood glucose level. On the basis of the FINDRISC, 80.2% were advised to change their lifestyle to prevent type 2 diabetes.

OBJECTIVE The aim of this study was to assess the efficacy of a 12-month prevention program conducted in 42 community pharmacies in reducing the risk for diabetes. RESEARCH DESIGN AND METHODS In a cluster-randomized controlled trial in 1,092 participants, mean change in the risk for diabetes (indicated by the Finnish Diabetes Risk Score [FINDRISC]) between intervention and control groups was calculated. In the intervention program GLICEMIA, three appointments with individual counseling and five educational group sessions were combined, whereas in the control group, only information about the participants’ health was obtained in three assessments. RESULTS After adjusting for cluster structure and differences in baseline characteristics, improvement in FINDRISC in the intervention group was 0.74 points (95% CI 0.42–1.04) above the control group. CONCLUSIONS The GLICEMIA program shows the feasibility of a pharmacy-based intervention and leads to a significant modest reduction in diabetes risk score but does not reduce the rate of diabetes progression over 1 year.

Background No overview of preventive health activities conducted by pharmacists in South Germany has been available until now. Moreover, little about the needs of the public is known with regard to pharmacy-based preventive services. Objectives To gain an overview of the preventive health services and campaigns carried out by pharmacists in the federal state of Bavaria, and to assess the interest of the public for pharmacy-based preventive care counselling. Setting Pharmacies in the seven Bavarian administrative districts, South Germany. Methods In September 2010, all 3,470 pharmacies in Bavaria were mailed a questionnaire concerning their preventive health activities. The pharmacists were given the opportunity to complete the questionnaire either online or to mail them in. To assess the needs of pharmacy-based preventive health services in the Bavarian population, customers of 50 pharmacies were invited to fill in an anonymous self-completion questionnaire in March 2011. Main outcome measure Relevant preventive health services which can be provided by pharmacists in order to meet the customers’ needs. Results 519 of 3,470 pharmacies (15.0 %) took part in the survey. 60.5 % (n = 314) conducted at least one preventive health activity in the past and 51.6 % (n = 268) offering a disease prevention education event at least once a year. As a result of the pharmacists’ survey, a ranking list of the most frequent preventive care activities was established. The projects conducted often lacked structured project schedules and evaluations. The survey assessing customer needs was completed by 1,808 customers in 49 of 50 community pharmacies. Pharmacists were identified as the preferred provider in 29 of the 31 preventive care services listed in the questionnaire. A ranking list with the top ten preventive subjects of highest interest was compiled. Conclusions Pharmacists are active in many different prevention subjects and there is a great interest in pharmacy-based preventive care counselling in the Bavarian population. Very few structured, well planned and evaluated preventive projects have been conducted in Bavarian community pharmacies. Further surveys are needed to analyse the benefit of pharmacy-based preventive care counselling for the Bavarian population.