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Benefits of a Community Pharmacy-based Intervention Program for People at Risk for T2D

The outcome of a 12-month prevention program conducted in 42 community pharmacies…

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A recently published meta-analysis showed that diabetes prevention in an outpatient setting can be effective; however, no studies have been developed to test how feasible and effective it would be. This study evaluates the feasibility and effectiveness of GLICEMIA, a diabetes prevention program implemented in the community pharmacies.

A total of 42 community pharmacies in South Germany participated in a non-blind random study that started in October 2012 and ended in January 2014. Pharmacies were randomly assigned to the intervention (GLICEMIA) group or the control group; and all pharmacists were trained to conduct the study. Patients were included if they had a German Finnish Diabetes Risk Score (FINDRISC) of 7 or more, and were at least 35 years old. All participants received written information about a healthy diet and physical activity. In addition to the written information, the control group were assessed and informed about their health status, while the GLICEMIA group received 3 individual counseling sessions about diet and physical activity and 5 group-based lectures that lasted 75-90 minutes covering: diabetes and risk factors, healthy diet, physical activity, psychological aspects of behavior change, and maintenance of a healthy lifestyle. The primary outcome was change in FINDRISC after 1 year, and secondary outcomes include: weight reduction, changes in blood pressure, self-reported physical activity, and quality of life.

A total of 40 pharmacies were included in the final intention-to-treat analysis. A comparison of baseline characteristics showed a significant difference in age, sex, family status, employment, BMI, FINDRISC, physical activity, and physical quality of life. The change in FINDRISC after 1 year for the GLICEMIA group was -0.55±1.84 points and 0.17±1.64 points for the control group. After adjusting for baseline differences (sex, age, BMI, employment, and level of education), improvement in FINDRISC was 0.74 points above the control group. There was a -1.57 kg weight loss in the GLICEMIA group, along with a significant improvement in physical activity and quality of life. No significant differences were found for blood pressure and mental quality of life.

The study showed that it was feasible to carry out the GLICEMIA program in the community pharmacies. Although the study showed the change in FINDRISC was significant, the authors state that further research is needed to assess the clinical relevance and whether there would be a reduction in the rate of participants developing diabetes.

Practice Pearls:

  • Diabetes prevention in a community setting can be effective.
  • Using individual counseling session and group-based lectures (GLICEMIA intervention program) can help decrease the risk of T2D.
  • Further studies are needed to assess the program’s clinical relevance.

Schmiedel K, Mayr A, Fiebler C, Schlager H, Friedland K. Effects of the Lifestyle Intervention Program GLICEMIA in People at Risk for Type 2 Diabetes: A Cluster-Randomized Controlled Trial. Diabetes Care. 17 March 2015. Web. 14 April 2014.