Impact of clinical pharmacists in medication management within the diabetic foot multidisciplinary team

Abstract

Background: Diabetic foot complications account for about 20% of diabetes-related hospital admissions worldwide and are a leading cause of non- traumatic lower limb amputations. In Saudi Arabia, approximately 3,970 diabetes-related amputations occur each year. Clinical pharmacists can enhance medication management and patient education for those with diabetic foot disease, although evidence of their impact is limited. The purpose of this study is to assess the effectiveness and role of a Clinical Pharmacist within a Multidisciplinary Diabetic Foot Team. Method: This retrospective, single- institution study involved two patient groups: those who visited the clinical pharmacist DM-Foot clinic (Group P1) and those who did not (Group P0). Primary outcomes included a composite measure of HbA1c, LDL reduction, no re-infection, and patient adherence. Secondary outcomes comprised LDL and HbA1c differences, re-infection, major/minor amputations, 30-day readmission rates, and mortality. Results: A total of 200 patients participated, with 100 in each group. The composite outcome was achieved by 100% of patients in Group P1 compared to 87% in Group P0 (P <0.001). Group P1 exhibited significant improvements in re-infection rates (34% vs 77%, p < 0.001), HbA1c reduction (75% vs 43%, p < 0.001), LDL reduction (78% vs 14%, p < 0.001), and medication adherence (93% vs 38%, p < 0.001). No significant differences were noted in mortality, readmission rates, or amputation rates between the groups. Conclusion: Clinical pharmacists significantly contribute to the diabetic foot multidisciplinary team, improving infection prevention and medication adherence.