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The British Journal of Diabetes & Vascular Disease
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Pharmacist-led structured care for patients with diabetic nephropathy

Christopher JG Kelly

Diabetes Unit, Stirling Royal Infirmary, Livilands, Stirling, UK, chriskelly{at}nhs.net

Gillian Booth

Diabetes Unit, Stirling Royal Infirmary, Livilands, Stirling, UK

Intensive multifactorial intervention reduces end points in patients with diabetic nephropathy. Traditional clinics struggle to provide the intensity of care required to meet targets for this growing patient group. We designed a pharmacist-led, protocol driven clinic to offer stepwise intensive treatment to patients with diabetic nephropathy picked up at the traditional secondary care clinic. One hundred and sixteen individuals received more than one review. The clinic achieved significant improvements in blood pressure (BP): systolic 151±19 mmHg vs.133±15 mmHg (p<0.001), diastolic 80±10 mmHg vs. 68±10 mmHg (p<0.001) and total cholesterol 4.56 mmol/L±1.05 mmol/L vs. 4.03±1.07 mmol/L (p<0.001). Albumin:creatinine ratio also improved 27±44 vs. 20±31 (p=0.02). Structured intervention within a pharmacist-led clinic has led to a rapid and significant reduction in BP and cholesterol in microalbuminuric patients. This format of care can form the basis of patient focused, target driven, care.

Key Words: diabetic nephropathy • healthcare delivery • pharmacist • structured care.

The British Journal of Diabetes & Vascular Disease, Vol. 8, No. 2, 86-88 (2008)
DOI: 10.1177/14746514080080020601
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?