Authors (including presenting author) :
Tse KY (1), LIU HKA(1), LAU YFE(2), Lo KW (1), Cheng WY (1), Fan SYC (1)
Affiliation :
(1) Pharmacy Department, Pamela Youde Nethersole Eastern
Hospital (2) Department of Medicine, Pamela Youde Nethersole
Eastern Hospital
Keyword 1: :
Pharmacist Clinic
Keyword 2: :
Drug Optimisation
Keyword 3: :
Drug Titration
Introduction :
Introduction: Managing chronic diseases requires ongoing optimisation of therapy to reach treatment goals and enhance patient outcomes. Interdisciplinary care models, particularly those involving pharmacist-led services, have emerged as a practical approach to enhancing patient care. This study assesses the impact of a protocol-driven Pharmacist-Led Drug Optimisation Clinic (PC) at Pamela Youde Nethersole Eastern Hospital (PYNEH).
Objectives :
The primary objectives of this service review were to assess the effectiveness of the Pharmacist-Doctor Collaboration under PC, compared to traditional care, in optimising the glycated haemoglobin A1C (HbA1c) in patients with pre-diabetes / diabetes and low-density lipoprotein cholesterol (LDLC) in patients with dyslipidemia.
Methodology :
A retrospective analysis was conducted to compare the Usual Care group (UC) and the Pharmacist-Doctor Collaboration group (PDC). The UC group included 761 patients for HbA1c analysis and 653 patients for LDLC analysis. These patients attended traditional medical clinics (Cardiology, Neurology, and General Medicine) between April 1, 2024, and March 31, 2025, and had not visited the Pharmacist Clinic. In contrast, the PDC group comprised 415 patients for HbA1c analysis and 424 patients for LDLC analysis. This group included patients who attended the PC at least once between July 1, 2023, and March 31, 2025. Changes in HbA1c (measured pre- and post-intervention with a minimum 90-day interval after clinic attendance) and LDLC (measured pre- and post-intervention with a minimum 42-day interval after clinic attendance) were analysed. To be included in the study, patients were required to have a pre-intervention HbA1c level greater than 5.6% or an LDL-C level greater than 1.8 mmol/L.
Result & Outcome :
The PDC group showed a statistically significant improvement in both clinical endpoints. For HbA1c, the PDC group achieved an average reduction of 0.1%, while the UC group experienced a slight increase of 0.03% (p< 0.05). Additionally, a significantly higher proportion of patients in the PDC group (211 out of 415, or 50.8%) reported a reduction in HbA1c compared to the UC group (312 out of 761, or 41.0%) (p< 0.05). Regarding LDLC, the average reduction in the PDC group was significantly greater, at 0.32 mmol/L, compared to the UC group, which had an average reduction of 0.12 mmol/L (p< 0.05). Furthermore, the proportion of patients achieving a reduction in LDLC was also higher in the PDC group (309 out of 424, or 72.9%) compared to the UC group (401 out of 653, or 61.4%) (p< 0.05). The PC has resulted in significant improvements in glycemic and lipid control. These findings highlight the effectiveness of a structured, pharmacist-driven interdisciplinary approach to optimising drug therapy for patients with chronic diseases. Additionally, they provide valuable insights for hospital administrators, equipping them with the knowledge necessary to implement and support such services in standard outpatient care, ultimately improving patient outcomes.
