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. 2023 May 31;2023(5):CD014513. doi: 10.1002/14651858.CD014513

Samtia 2013.

Study characteristics
Methods A multifactorial intervention to enhance adherence to medications and disease‐related knowledge in type 2 diabetic patients in Southern Punjab, Pakistan
RCT (NA clusters and NA providers), conducted in 1) Carried out for a 5‐month period in selected diabetes clinics in southern Punjab (Nishter Hospital Multan and DHQ Hospital Layyah), 2) Five pharmacists were the part of the study team in Pakistan
2 arms: 1. Control (usual care) (control arm) and 2. Intervention (pharmacist led predefined care) (intervention arm)
Participants Control arm N: 170
Intervention arm N: 178, NA, NA
Diabetes type: 2
Mean age: 44.24 ± NR
% Male: 50.55
Longest follow‐up: 5 months
Interventions Control arm: (usual care)
Intervention arm: (pharmacist‐led predefined care)
1) Case management
2) Patient education
3) Promotion of self‐management
Outcomes Glycated haemoglobin
Smoking status
Funding source Not reported
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not reported.
Allocation concealment (selection bias) Unclear risk Not reported.
Patient's baseline characteristics (selection bias) Low risk Table 1, data looks similar.
Patient's baseline outcomes (selection bias) Unclear risk Table 1, data looks similar.
Incomplete outcome data (attrition bias) Low risk Almost all the patients included completed the study (control group: 168/170 and intervention group: 174/178). Reasons for dropout were mainly non‐affordability of medication and travelling costs to keep hospital appointments. Lack of motivation and one patient died during follow‐up.
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias) High risk Self‐report. Patients included in both control and intervention groups were asked to perform fasting blood sugar tests every 4 weeks at 0, 4, 8, 12, 16 and 20 weeks. Patients were asked to test their HbA1c values at the start and at the end of the study. Self‐reporting approach was used to assess adherence to medications. Knowledge regarding disease, self‐monitoring and lifestyle modifications were assessed on no basis at the start and end of the study.
Selective reporting (reporting bias) Unclear risk No protocol registered. Methods match outcomes.
Risk of contamination (other bias) Unclear risk Unclear whether intervention pharmacists interacted with control patients.
Other bias Low risk None identified.