***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: AIMS To determine whether an extended pharmacy service would improve glycaemic control and cardiovascular risks in diabetic Muslims . METHODS Ambulatory literate adult diabetic Muslims with A1C > 7 % were r and omly assigned to either a study group ( usual care plus added pharmacist input , N=63 ) or a  control group ( usual care only , N=67 ) . On four consecutive visits , at 2-month intervals , the study group met a pharmacist who educated and discussed with each patient regarding medication uses and diabetic treatment . This was accompanied by providing a diabetic pamphlet .  Changes in A1C ( mg/dL ) , lipid parameters ( mg/dL ) , medication adherence ( % pill count ) and diabetic knowledge scores were measured . RESULTS There was no difference in A1C reduction between the study and the control groups ( -0.8 vs. -0.6 , p=0.56 ) . Total cholesterol and LDL-C improvements were greater in the study group than in the control group ( -31.6 vs. -1.2 , p=0.000 ; -15.0 vs. + 9.1 , p=0.002 , respectively ) . The percent pill count ( + 6.8 vs. -2.8 , p=0.004 ) and diabetic knowledge scores ( + 2.1 vs. + 0.6 , p=0.002 ) were increased in the study group but not in the control group . CONCLUSION The pharmacist ' s one-on-one education on diabetes accompanied by its pamphlet , in Muslim patients with diabetes did not affect glycaemic outcome but reduction in cardiovascular risks through lowering total cholesterol and LDL-C was found . The strategies may also improve diabetic knowledge and medication adherence PURPOSE Rural low-income African American patients with diabetes have traditionally poorer clinical outcomes and limited access to state-of-the-art diabetes care . We determined the effectiveness of a re design ed primary care model on patients ’ glycemic , blood pressure , and lipid level control . METHODS In 3 purposively selected , rural , fee-for-service , primary care practice s , African American patients with type 2 diabetes received point-of-care education , coaching , and medication intensification from a diabetes care management team made up of a nurse , pharmacist , and dietitian . In 5 r and omly selected control practice s matched for practice and patient characteristics , African American patients received usual care . Using univariate and multivariate adjusted models , we evaluated the effects of the intervention on intermediate ( median 18 months ) and long-term ( median 36 months ) changes in glycated hemoglobin ( hemoglobin A1c ) levels , blood pressure , and lipid levels , as well as the proportion of patients meeting target values . RESULTS Among 727 r and omly selected rural African American diabetic patients ( 368 intervention , 359 control ) , intervention patients had a significantly greater reduction in mean hemoglobin A1c levels at intermediate ( −0.5 % vs −0.2 % ; P < .05 ) and long-term ( −0.5 % vs −0.10 % ; P < .005 ) follow-up in univariate and multivariate models . The proportion of patients achieving a hemoglobin A1c level of less than 7.5 % ( 68 % vs 59 % , P < .01 ) and /or a systolic blood pressure of less than 140 mm Hg ( 69 % vs 57 % , P < .01 ) was also significantly greater in intervention practice s in multivariate models . CONCLUSION Re design ing care strategies in rural fee-for-service primary care practice s for African American patients with established diabetes results in significantly improved glycemic control relative to usual care OBJECTIVE To describe the beneficial long-term effects of an average of 6.5 years of intensive diabetes therapy ( INT ) in type 1 diabetes on measures of atherosclerosis , cardiac structure and function , and clinical cardiovascular events observed in the Diabetes Control and Complications Trial ( DCCT ) and the Epidemiology of Diabetes Interventions and Complications ( EDIC ) study . RESEARCH DESIGN AND METHODS The DCCT was a r and omized clinical trial of 1,441 participants assigned to receive INT or conventional therapy ( CON ) .  It was conducted between 1983–1993 with an average follow-up of 6.5 years . EDIC ( 1994–present ) is an observational follow-up of the DCCT cohort . Cardiovascular events have been recorded throughout . During EDIC common carotid intima-media thickness ( IMT ) was measured with ultrasound , coronary artery calcification with computed tomography , and cardiac structure and function with cardiac magnetic resonance imaging . RESULTS DCCT INT and lower levels of HbA1c during DCCT/EDIC were associated with thinner carotid IMT , less coronary calcification , and a lower incidence of clinical cardiovascular events including myocardial infa rct ion , stroke , and cardiac death . While there were no significant differences in cardiac structure and function between the former INT and CON groups , they were significantly associated with higher HbA1c during DCCT/EDIC . CONCLUSIONS DCCT INT and the attendant 6.5 years of lower HbA1c had long-term salutary effects on the development and progression of atherosclerosis and cardiovascular disease during the subsequent follow-up during EDIC BACKGROUND Clinical practice recommendations from American Diabetes Association ( ADA ) include specific prevention goals intended to reduce the risk of diabetic complications . The Healthy People 2010 ( HP2010 ) initiative , up date d to Healthy People 2020 , proposes similar objectives for improvement of clinical measures and outcomes in patients with diabetes .  Clinical pharmacists are gaining an increasing role in providing diabetes management services , including collaborative practice in medical groups . OBJECTIVE To compare the rates of attainment of diabetes prevention goals described by the ADA 2009 guidelines and the HP2010 initiative for patients receiving clinical pharmacist interventions in a collaborative practice diabetes clinic versus patients receiving usual care .  METHODS The setting is a primary care clinic affiliated with a 140-physician multispecialty medical group in the upper Midwest . Diabetes patients were identified from electronic medical records by ICD-9-CM diagnosis codes 250.00 through 250.99 for date s of service in the 12-month period from January 1 , 2007 , through December 31 , 2007 . Study subjects had to be aged 18 years or older and have at least 2 visits to a primary care physician ( PCP ) or the pharmacist-managed diabetes clinic during 2007 . Descriptive statistics and chi-square analysis were utilized . RESULTS Of 7,068 patients at least 18 years of age with at least 1 diabetes diagnosis code for a medical encounter in 2007 , 1,298 ( 18.4 % ) had a least 1 visit in the pharmacist-managed diabetes clinic , and 321 patients ( 4.5 % ) had 2 or more visits . These 321 patients were compared with 321 patients stratified by gender and r and omly selected from 3,022 patients who had at least 2 visits with a PCP and no visits in the pharmacist-managed diabetes clinic in 2007 . Nine of the 14 HP2010 objectives ( 64.3 % ) were attained in the intervention group compared with 7 of 14 ( 50.0 % ) in the usual care group . For patients with hypertension at baseline , 44.6 % ( 120/269 ) in the intervention group versus 48.0 % ( 123/256 ) in the usual care group achieved goal blood pressure ( P = 0.430 ) . The low-density lipoprotein ( LDLC ) goal ( less than 100 milligrams per deciliter ) was achieved in 76.0 % of patients in the intervention group ( 244/321 ) versus 59.2 % ( 190/321 ) in usual care ( P less than 0.001 ) . Fewer patients in the intervention group achieved hemoglobin A1c less than 7 % ( 50.8 % , n = 163/321 ) compared with usual care ( 71.0 % , n = 228/321 , P less than 0.001 ) . The proportions of patients with influenza and pneumococcal vaccinations were higher in the intervention group versus the usual care group for 3 of 4 comparisons by age , but neither group met the target goals . CONCLUSIONS Patients who were seen by the clinical pharmacists met more of the preventive care objectives recommended by the ADA 2009 and HP2010 initiatives ; however , more patients in usual care met the A1c goal compared with pharmacist-managed patients . The absence of baseline values for A1c , blood pressure , and LDL-C prevented longitudinal assessment of the effects of this clinical pharmacist intervention Many patients with diabetes do not receive recommended st and ards of care . Diabetes patients were seen by a pharmacist in a diabetes assessment service ( DAS ) 1 week prior to a physician appointment to complete diabetes st and ards . Completion rates of American Diabetes Association ( ADA ) st and ards were compared between patients of 5 physicians offered the DAS intervention and a concurrent cohort of r and omly selected patients of nonparticipating physicians . A total of 94 patients were seen by DAS ; 210 patients comprised the controls . DAS patients had a significantly higher proportion of each st and ard completed ( glycosylated hemoglobin , lipids , foot exam , eye referral , pneumococcal and influenza vaccination , and urine microalbumin ) compared with the control group ( P < .001 ) . An average of 3.3 ± 1.8 diabetes st and ards per patient were completed . A planned visit with a pharmacist prior to a physician appointment , with the goal of completing ADA st and ards of care , was feasible and effective in this university-based family medicine center BACKGROUND : This study was conducted to evaluate the effect of a clinical pharmacist-led patient education program for type 2 diabetic patients at Isfahan Endocrine & Metabolism Research Center ( IEMRC ) from April 2008 to January 2009 . METHODS : In a r and omized controlled clinical trial , a total of 172 patients with uncontrolled type 2 diabetes were selected and r and omly allocated into control and intervention groups . After taking informed written consent , the intervention group received an educational program about oral anti-hyperglycemic medications , adherence , diabetes dairy log and pill box usage . Patient 's glycemic control in the intervention group was followed for three months through either telephone or face to face interviews with the pharmacist .  Fasting blood glucose and HbA1c were measured at the start and end of the pharmacistled drug education program for both intervention and control groups . RESULTS : After a three months follow-up , mean fasting blood glucose and HbA1c of the patients in the intervention group decreased significantly compared to control group ( p < 0.001 ) . CONCLUSIONS : This study demonstrates an improvement in diabetes management of type 2 diabetics by involving a pharmacist in the multidisciplinary teams in the outpatient clinics . The results suggest the benefits of adding adherence education to the diabetic education programs AIMS The primary aim of this study was to evaluate the impact of pharmaceutical care interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes patients in Jordan . METHODS A r and omized controlled clinical trial was conducted on 106 patients with uncontrolled type 2 diabetes seeking care in the diabetes clinics at Jordan University Hospital . Patients were r and omly allocated into control and intervention group . The intervention group patients received pharmaceutical care interventions developed by the clinical pharmacist in collaboration with the physician while the control group patients received usual care without clinical pharmacist 's input .  Fasting blood glucose and HbA1c were measured at the baseline , at three months , and six months intervals for both intervention and control groups . RESULTS After the six months follow-up , mean of HbA1c and FBS of the patients in the intervention group decreased significantly compared to the control group patients ( P<0.05 ) . Also , the results indicated that mean scores of patients ' knowledge about medications , knowledge about diabetes and adherence to medications and diabetes self-care activities of the patients in the intervention group increased significantly compared to the control group ( P<0.05 ) . CONCLUSIONS This study demonstrated an improvement in HbA1c , FBS , and lipid profile , in addition to self-reported medication adherence , diabetes knowledge , and diabetes self-care activities in patients with type 2 diabetes who received pharmaceutical care interventions .  The results suggest the benefits of integrating clinical pharmacist services in multidisciplinary healthcare team and diabetes management in Jordan BACKGROUND Clinical pharmacy services ( CPS ) in the primary care setting have been shown to help patients attain treatment goals and improve outcomes . However , the availability of CPS in community-based primary care is not widespread . One reason is that current fee-for-service models offer limited reimbursement opportunities for CPS in the community setting . Furthermore , data demonstrating the value of CPS in this setting are limited , making it difficult for providers to determine the feasibility and sustainability of 
    Output:
    
Conclusion : Pharmacists ’ interventions as part of the patient ’s health care team improved diabetes therapeutic outcomes , substantiating the important role of pharmacists in team-based diabetes management