***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Malaria accounts for over 40 % of all outpatient consultations in Ghana . A common drug use problem associated with its treatment with chloroquine is over- and under-dosage and a preference for the intramuscular route of administration . Inadequate treatment is an important factor in the selection of resistant strains of malaria parasites . To ensure the proper management of diseases at health centres the Ministry of Health instituted an in-service training programme for medical assistants in 1987 . We evaluated the effect of this training on the clinical management of malaria using a quasi-experimental design . Three methods of data collection were used ; prescription survey , assessment question naires and focus group discussion s. Our findings revealed that gains in knowledge following the training had deteriorated within a year . There was also a discrepancy between knowledge and practice of malaria treatment . This was shown by over- and under-dosing of chloroquine in children and adults respectively . There was also overwhelming preference ( 85 % of all cases ) for injections and a high tendency towards polypharmacy ( average of five drugs per visit ) . The motivating reasons for these were mainly socio-cultural and included patient dem and and attitudes , prescriber self interests and stereotypes and the daily practical challenges of the community . While paying greater attention to supervision of clinical work at health posts , consideration must be given to socio-cultural context of drug use in any such future training programmes if rational use of drugs is to be achieved Objective Diabetes mellitus is a serious health problem associated with an increased mortality and morbidity . The association of improved glycemic control with sustained decrease in the rate of complications has been shown in r and omized clinical trials . Pharmaceutical care is a relatively new concept in Turkey ; yet , there are no recorded routine pharmaceutical care programs . Therefore , we aim ed to assess the impact of a short pharmaceutical care program conducted in the community pharmacy setting , on the indices of diabetes care of type 2 diabetic patients , particularly those regarding glycemic control and high blood pressure management . Setting The study was carried out at eight community pharmacies in Pendik district of Istanbul . Method All patients who visited any of the eight pharmacies through the pre-determined 1-week period were question ed for the presence of type 2 diabetes . Patients who reported to be type 2 diabetic ( n = 67 ) were informed about the study and invited to involve . During this prospect i ve longitudinal study , pharmaceutical care was provided to the patients by the same clinical pharmacist . The 3 month pharmaceutical care period consisted of six pharmacy visits . Main outcome measure : The main outcome measures were the improvement in glycemic control and blood pressure control ; while , weight control , self-monitoring of blood glucose , compliance and being under physician-control were also assessed . Results The study was conducted on 43 patients who accepted to involve .  Fasting blood glucose was lowered by a mean of 23 % over 3-months from an initial value of 167.2 mg/dl . Number of patients reaching the desired blood glucose goals increased from 16.3 % to 39.5 % . Systolic and diastolic blood pressures also significantly fell over 3 months ( mean reductions were 10.9 mmHg for the systolic and 9.3 mmHg for the diastolic blood pressure ) . Number of patients reaching the desired blood pressure goal increased from 30.2 % to 51.2 % . Conclusion Our short-course pharmaceutical care program yielded measurable improvements in clinical indicators of diabetes and comorbidity management . The results suggest that the pharmacist is a beneficial key component of integrated care for patients with type 2 diabetes . We think that the positive results observed in this first reported pharmaceutical care program on diabetes in Turkey can be motivating and encouraging for all community pharmacists BACKGROUND type 2 diabetes mellitus continues to increase in prevalence worldwide . Many factors have been cited as contributing to compliance , such as family and social support , education , number of tablets per dose , frequency of administration and health care provider communication . Toward these goals , the present study was developed to measure the effect offactors on glycemic control such as diabetes education by pharmacists , a diabetes disease booklet and special medication containers . MATERIAL AND METHOD A total of 360 volunteers with type 2 DM patients were recruited , participants were simple r and omized to control 180 and intervention 180 patients . Which intervention categorized to 4 groups ; all intervention groups received diabetes drug counseling by a pharmacist , one group received plus a diabetes booklet , one received plus special medical containers and the last group received all of them . The interventions were done at the 1st time of visit . Both the control and intervention groups were monitored for fasting plasma glucose and HbA1c at 0 , 3 , 6 months and glycemic level in both groups was compared . RESULTS After 3 months , mean fasting plasma glucose and HbA1c decreased wiih the intervention group vs. control group ( 152.36 + /- 39.73 to 131.52 + /- 35.22 mg% ) and ( 150.16 + /- 41.78 to 153.98 + /- 47.95 mg% ) respectively ; ( p < 0.001 ) . HbA1c level 8.16 + /- 1.44 to 7.72 + /- 1.26 vs 8.01 + /- 1.51 to 8.38 + /- 1.46 respectively ; ( p < 0.001 ) . After 6 months , mean fasting plasma glucose and HbA1c decreased with the intervention group vs. control group ( 152.36 + /- 39.73 to 145.20 + /- 46.07 mg% ) and ( 150.16 + /- 41.78 to 159.16 + /- 54.90 mg% ) respectively ; ( p < 0.013 ) . HbA1c level 8.16 + /- 1.44 to 7.91 + /- 1.27 vs. 8.01 + /- 1.51 to 8.80 + /- 1.36 respectively ; ( p < 0.001 ) . The most favorable glycemic outcome was the group that received all of the interventions ; mean FPG was reduced from 147.46 + /- 36.07 to 125.38 + /- 31.12 mg% ( p < 0.000 ) in 1nd visit ( 3 months later ) and still reducing effect on the 2nd visit ( 6 month later ) mean FPG from 147.46 + /- 36.07 to 130.21 + /- 33.96 mg% ( p < 0.016 ) also the same way in HbA 1c level . The group that received only drug counseling by pharmacist had no significant reduction in FPG and HbA1c . ( p > 0.05 ) . CONCLUSION Drug counseling by a pharmacist has little beneficial effect on diabetes management outcome compared to the diabetes booklet and special drug container . To improve glycemic control of type 2 DM is to integrate self-management in daily life , wide a variety of education , drug taken behavior and health care provider available communication produce improvement in patient management and is somewhat better when used in combination Background Childhood asthma is common in Cape Town , a province of South Africa , but is underdiagnosed by general practitioners . Medications are often prescribed inappropriately , and care is episodic . The objective of this study is to assess the impact of educational outreach to general practitioners  on  asthma symptoms of children in their practice . Methods This is a cluster r and omised trial with general practice s as the unit of intervention , r and omisation , and analysis . The setting is Mitchells Plain ( population 300,000 ) , a dormitory town near Cape Town . Solo general practitioners , without nurse support , operate from storefront practice s. Caregiver-reported symptom data were collected for 318 eligible children ( 2 to 17 years ) with moderate to severe asthma , who were attending general practitioners in Mitchells Plain . One year post-intervention follow-up data were collected for 271 ( 85 % ) of these children in all 43 practice s. Practice s r and omised to intervention ( 21 ) received two 30-minute educational outreach visits by a trained pharmacist who left material s describing key interventions to improve asthma care . Intervention and control practice s received the national childhood asthma guideline . Asthma severity was measured in a parent-completed survey administered through schools using a symptom frequency and severity scale . We compared intervention and  control group children on the change in score from pre-to one-year post-intervention . Results Symptom scores declined an additional 0.84 points in the intervention vs. control group ( on a nine-point scale . p = 0.03 ) . For every 12 children with asthma exposed to a doctor allocated to the intervention , one extra child will have substantially reduced symptoms . Conclusion Educational outreach was accepted by general practitioners and was effective . It could be applied to other health care quality problems in this setting Objective The study aim ed at evaluating the effect of pharmaceutical care programme on blood pressure and quality of life of patients who visit a Nigerian community pharmacy . Method A non-r and omised , single-site , crossover design was used . Patients served as their own control . They underwent 5 months of usual care and another 5 months of pharmaceutical care . Main outcome measure Blood pressure and quality of life measured before implementation of pharmaceutical care and at the end served as main outcome measures . Other end-points assessed at baseline and at the end of investigation included smoking cessation , adherence to therapy , exercise , salt restriction , alcohol moderation and self blood pressure measurement . Results Twenty four ( 24 ) patients out of the 40 recruited completed the study . Mean reductions were significant after pharmaceutical care intervention  for systolic BP ( 14.3 ± 14.4 mmHg ) and diastolic BP ( 10.8 ± 10.7 mmHg ) . There was a significant mean increase in number of patients that adhered to salt restriction ( −36 % ) , aerobic exercise ( −46 % ) , self BP measurement ( −46 % ) , alcohol moderation ( −33 % ) and drug adherence ( −16.7 % ) . There was a positive increase of −11.4 and −3.2 for physical health and social health domain of quality of life evaluation respectively . Conclusion Pharmaceutical care programme could produce a beneficial effect on hypertensive patients BACKGROUND The practice of pharmaceutical care in primary care setting s in Thail and is currently not generally accepted . OBJECTIVE To evaluate the effect of pharmacist involvement in treatment with hypertensive patients in primary care setting s. METHODS The treatment objective was to stabilize the blood pressure ( BP ) of hypertensive patients in accordance with the Joint National Committee on Prevention , Detection , Evaluation and Treatment of High Blood Pressure guidelines . Patients were r and omly assigned to a pharmacist-involved group ( treatment ) or a group with no pharmacist involvement ( control ) . Pre- and post-test BPs , tablet counts , lifestyle modifications , and pharmacists ’ recommendations were recorded . The 6-month study was carried out in Mahasarakham University pharmacy and 2 primary care units . Patients were monitored monthly by review ing their medications and supported by providing pharmaceutical care and counseling . RESULTS From a total of 235 patients , the treatment group ( n = 118 ) had a significant reduction in both systolic ( S ) and diastolic ( D ) BP compared with the 117 patients of the control group ( p = 0.037 , 0.027 , respectively ) . The 158 patients ( 76 treatment , 82 control ) with BPs 140/90 mm Hg at the beginning of the study showed significant BP reductions ( p = 0.002 SBP , 0.008 DBP ) . The proportion of 158 patients whose BP became stabilized was higher in the treatment group ( p = 0.017 ) . The treatment group showed significantly better adherence ( p = 0.014 ) and exercise control ( p = 0.012 ) at the end of the study . Physicians accepted 42.72 % of medication modifications and 5.34 % of the suggestions for additional investigations . CONCLUSIONS Hypertensive patients who received pharmacist input  achieved a significantly greater benefit in BP reduction , BP control , and improvement in adherence rate and lifestyle modification Background : The number of inappropriate prescriptions for sexually transmitted infections ( STIs ) in Sudan is suspected to be high . Simple multifaceted interventions directed at prescribers may improve prescribing patterns in the Sudan . Objective : To evaluate the effect of multifaceted interventions on prescribing for STIs in the White Nile State , Sudan . Methods : The study involved 20 health centres r and omly assigned to four different multifaceted interventions to improve prescribing . Results : Prescriber targeted interventions involving audit and feedback together with academic detailing and practice guidelines reduced the number of inappropriate prescriptions by 50 % ( p<0.001 ) . Audit and feedback together with seminars and practice guidelines  reduced inappropriate prescriptions by 43 % ( p<0.001 ) . Audit and feedback alone 
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Health service utilisation , such as rate of hospitalisation and general practice and emergency room visits , was also found to be reduced by the patient targeted pharmacist-provided services .
Pharmacist-provided services that target patients may improve clinical outcomes such as management of high glucose levels among diabetic patients , management of blood pressure and cholesterol levels and may improve the quality of life of patients with chronic conditions such as diabetes , hypertension and asthma .
Pharmacist services may reduce health service utilisation such as visits to general practitioners and hospitalisation rates .