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Impact of clinical pharmacists intervention on management of hyperglycemia in pregnancy in Jordan

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Abstract

Background and objective Hyperglycemia in pregnancy is a risk factor for cardiovascular disease and postpartum (PP) diabetes. This study aimed to assess the impact of the clinical pharmacist-assisted program (CPAP) of optimizing drug therapy and intensive education on main management outcome measures of patient knowledge about diabetes, Quality of life (QoL) as measured by SF-36 including maternal complications, fasting plasma glucose (FPG) control, and HbA1c. Method This is a randomized controlled study. Pregnant (20–28 weeks) patients with hyperglycemia received CPAP (n = 51) as compared with conventional management (n = 34). Patients were then followed up for 6 weeks pp. Results A significant change was shown in the intervention group for diabetes knowledge (3.47% vs. control 2.03%, P < 0.05) and three aspects of health-related QoL. The need for caesarian delivery (58.8% vs. control 35.3%) and severe episodes of hypoglycemia (0% vs. control 8.8%) were significantly (P < 0.05) reduced in the intervention group. Six weeks PP reduction in HbA1c values was greater in the intervention group (− 0.54% vs. control − 0.08%, P = 0.04) with more FPG-controlled patients during pregnancy (94% vs. control 64.7%). Conclusion Clinical pharmacist assisted services in the management of pregnancy hyperglycemia fundamentally and significantly improve knowledge and disease control.

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References

  1. American Diabetes Association (ADA) Standards of medical care in diabetes. http://professional.diabetes.org/sites/professional.diabetes.org/files/media/dc_40_s1. Accessed 19 Jan 2017.

  2. Centers for disease control and prevention (CDC). National center for health statistics, National diabetes fact sheet. https://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. Accessed 3 Sep 2016.

  3. Zalzala B, Hijazi S, Al-Kuran O. Prevalence of gestational diabetes mellitus in North of Jordan. Master’s thesis, Faculty of graduate studies, The Jordan University of Science and Technology, 2009.

  4. Elnour A, El Mugammar T, Jaber T, Revel T, McElnay JC. Pharmaceutical care of patients with gestational diabetes mellitus. J Eval Clin Pract. 2006;14:131–40.

    Article  Google Scholar 

  5. Inturrisi M, Lintner NC, Sorem KA. Diagnosis and treatment of hyperglycemia in pregnancy. Endocrinol Metab Clin N Am. 2011;40:703–26.

    Article  CAS  Google Scholar 

  6. Petrovic O, Belci D. A critical appraisal and potentially new conceptual approach to screening and diagnosis of gestational diabetes. J Obstet Gynaecol. 2017;37:691–9.

    Article  PubMed  Google Scholar 

  7. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352:2477–86.

    Article  CAS  PubMed  Google Scholar 

  8. Zhao P, Liu E, Qiao Y, Katzmarzyk P, Chaput J, Fogelholm M, et al. Maternal gestational diabetes and childhood obesity at age 9–11: results of a multinational study. Diabetolgia. 2016;125:4062–9.

    Google Scholar 

  9. Guy GP, Ling HZ, Garcia P, Poon LC, Nicolaides KH. Maternal cardiovascular function at 35–37 weeks’ gestation: relation to maternal characteristics. Ultrasound Obstet Gynecol. 2016;. https://doi.org/10.1002/uog.17311.

    PubMed  Google Scholar 

  10. Hopmans TE, van Houten C, Kasius A, Kouznetsova OI, Nguyen LA, Rooijmans SV, et al. Increased risk of type II diabetes mellitus and cardiovascular disease after gestational diabetes mellitus: a systematic review. Ned Tijdschr Geneeskd. 2015;159:A8043.

    PubMed  Google Scholar 

  11. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Health Syst Pharm. 1990;47:533–43.

    CAS  Google Scholar 

  12. Assal JP, Jacquemet S, Morel Y. The added value of therapy in diabetes: the education of patients for self-management of their disease. Metab Clin Exp. 1997;1197(46):61–4.

    Article  Google Scholar 

  13. Fitzgerald JT, Martha MF, George EH, Patricia AB. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21:706–10.

    Article  CAS  PubMed  Google Scholar 

  14. Howorka K, Pumprla J, Gabriel M, Feiks A, Schlusche C, Nowotny C, et al. Normalization of pregnancy outcome in pre-gestational diabetes through functional insulin treatment and modular out-patient education adapted for pregnancy. Diabet Med. 2001;18:965–72.

    Article  CAS  PubMed  Google Scholar 

  15. Evans E, Patry R. Management of gestational diabetes mellitus and pharmacists’ role in patient education. Am J Health Syst Pharm. 2004;61:1460–5.

    PubMed  Google Scholar 

  16. Butt M, Ali A, Bakry M, Mustafa N. Impact of a pharmacist led diabetes mellitus intervention on HbA1c, medication adherence and quality of life: a randomized controlled study. Saudi Pharm J. 2016;24:40–8.

    Article  PubMed  Google Scholar 

  17. Turok D, Ratcliffe S, Baxley E. Management of gestational diabetes. Am Fam Phys. 2003;86:1767–72, 1775–6.

  18. Quinones M, Pio M, Chow D, Moss E, Hulstein J, Boatright S, et al. Impact of clinical pharmacy services on outcomes and costs for indigent patients with diabetes. Am J Manag Care. 2016;22:e147–52.

    PubMed  Google Scholar 

  19. Kim C, Newton K, Knopp R. Gestational diabetes and the incidence of type 2 diabetes. Diabetes Care. 2002;25:1862–8.

    Article  PubMed  Google Scholar 

  20. Moon JH, Kwak SH, Jang HC. Prevention of type 2 diabetes mellitus in women with previous gestational diabetes mellitus. Korean J Intern Med. 2017;32:26–41.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hopmans TE, van Houten C, Kasius A, Kouznetsova OI, Nguyen LA, Rooijmans SV, et al. Increased risk of type II diabetes mellitus and cardiovascular disease after gestational diabetes mellitus: a systematic review. Ned Tijdschr Geneeskd. 2015;2015(159):A8043.

    Google Scholar 

  22. Ebert T, Kralisch S, Wurst U, Lossner U, Kratzsch J, Bluher M, et al. Betatrophin levels are increased in women with gestational diabetes mellitus compared to healthy pregnant controls. Eur J Endocrinol. 2015;173:1–7.

    Article  CAS  PubMed  Google Scholar 

  23. Dishi M, Hevner K, Qiu C, Fida NG, Abetew DF, Williams MA, et al. Early pregnancy maternal hepatocyte growth factor and risk of gestational diabetes. Br J Med Med Res. 2015;9:1–13.

    Article  Google Scholar 

  24. Stein S, Stepan H, Kratzsch J, Verlohren M, Verlohren HJ, Drynda K, et al. Serum fibroblast growth factor 21 levels in gestational diabetes mellitus in relation to insulin resistance and dyslipidemia. Metab Clin Exp. 2010;59:33–7.

    Article  CAS  PubMed  Google Scholar 

  25. Singh M, Pathak MS, Paul A. A study on atherogenic indices of pregnancy induced hypertension patients as compared to normal pregnant women. J Clin Diagn Res. 2015;9(7):BC05–8. https://doi.org/10.7860/JCDR/2015/13505.6241.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Bharadwaj R, Mathur K, Sharma D, Sankhla M. The relationship between oxidative stress and atherogenic index (A.I.) in preeclampsia. Sch J Appl Med Sci. 2014;2(6D):3092–6.

    Google Scholar 

  27. Aragon-Charris J, Reyna-Villasmil E, Guerra-Velasquez M, Mejia-Montilla J, Torres-Cepeda D, Santos-Bolivar J, et al. Atherogenic index of plasma in patients with preeclampsia and in healthy pregnant women. Med Clin. 2014;143(3):104–8.

    Article  Google Scholar 

  28. Zhang Y, Zhang HH, Lu JH, Zheng SY, Long T, Li YT, et al. Changes in serum adipocyte fatty acid-binding protein in women with gestational diabetes mellitus and normal pregnant women during mid- and late pregnancy. J Diabetes Investig. 2016;7(5):797–804.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank the National Center for Diabetes, Endocrinology, and Genetics for opening their doors and all the appreciation to the center’s honorable healthcare staff in providing the needed support.

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Authors and Affiliations

  1. University of Jordan, Amman, Jordan

    Razan Adnan Batta, Violet Kasabri, Amal Akour & Abla Albsoul-Younes

  2. National center for Diabetes, Endocrinology and Genetics, Amman, Jordan

    Dana Hyassat

Authors
  1. Razan Adnan Batta
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  2. Violet Kasabri
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  3. Amal Akour
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  4. Dana Hyassat
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  5. Abla Albsoul-Younes
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Correspondence to Violet Kasabri.

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Funding

This project was funded by The University of Jordan- Deanship of Academic Research.

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The authors declare that they have no conflicts of interest.

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Batta, R.A., Kasabri, V., Akour, A. et al. Impact of clinical pharmacists intervention on management of hyperglycemia in pregnancy in Jordan. Int J Clin Pharm 40, 48–55 (2018). https://doi.org/10.1007/s11096-017-0550-3

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  • DOI: https://doi.org/10.1007/s11096-017-0550-3

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