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Community Pharmacist-Led Interventions in Patients with Type 2 Diabetes in Low-and Middle-Income Countries: A Scoping Review
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  • Indriastuti Cahyaningsih,
  • Maarten Lambert,
  • Taichi Ochi,
  • Fang Li,
  • Xinyu Li,
  • Petra Denig,
  • Katja Taxis
Indriastuti Cahyaningsih
University of Groningen

Corresponding Author:i.cahyaningsih@rug.nl

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Maarten Lambert
University of Groningen
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Taichi Ochi
Rijksuniversiteit Groningen
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Fang Li
Rijksuniversiteit Groningen
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Xinyu Li
Rijksuniversiteit Groningen
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Petra Denig
University Medical Center Groningen
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Katja Taxis
Rijksuniversiteit Groningen
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Abstract

Aims. To provide an overview of the types of interventions performed by community pharmacists and describe their effects on patients with type 2 diabetes mellitus (T2DM) in low- and middle-income countries (LMICs). Methods. This review was conducted according to the PRISMA-Scr guidelines. PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for (non-) randomized controlled, before-after, and interrupted time series design. There was no restriction in the publication language. Included interventions had to be delivered by community pharmacists in primary care and community settings. The study quality was assessed using the National Institute of Health tools. Results were analyzed descriptively. Results. Twenty-eight studies were included representing 4,434 patients (mean age from 47.4 to 59.5 years, 55.4% female). Four studies were single- and the remaining studies were multiple-component interventions. Face-to-face counseling of patients was the most common intervention, often combined with providing printed materials, remote consultations, or conducting medication reviews. Generally, studies showed improved outcomes in the intervention group, including clinical, patient-reported and medication safety outcomes. In most studies at least one domain was judged to be of poor quality, with heterogeneity among studies. Conclusions. Community pharmacist-led interventions among T2DM patients showed positive effects in LMICs, but the quality of the evidence was poor. Face-to-face counseling of varying intensity, often combined with other strategies, was the most common type of intervention. Although these findings support the expansion of the role of the community pharmacist in diabetes care in LMICs, better quality studies are needed to evaluate further impact.