Background The role of a pharmacist in primary health care settings of Pakistan is still obscure. Thus, we aimed to demonstrate the pharmacist-led improvements in glycemic, blood pressure and lipid controls in type 2 diabetes mellitus (T2DM) patients of Lahore, Pakistan. Methods The first open label, randomized control trial conducted at a primary health care facility of Lahore, Pakistan by enrolling 244 uncontrolled type 2 diabetes (hemoglobin A1 c, (HbA1c); 10.85 ± 1.74) patients. The pharmacological intervention included identification of drug related problems, drug interactions, change in dose, frequency and therapy switches in collaboration with physician, while non-pharmacological intervention consisted of diet, lifestyle and behavior counseling. Outcome measures were glycemic (HbA1c), blood pressure and lipid controls. Results In intra-group comparison, compared to control arm ( C , n = 52), subjects in the intervention arm ( I , n = 83) demonstrated significant differences in process outcome measures; baseline vs final, such as HbA1c ( C ; 10.3 ± 1.3 vs 9.7 ± 1.3, p < 0.001, I ; 10.9 ± 1.7 vs 7.7 ± 0.9, p < 0.0001), systolic blood pressure (SBP) ( C ; 129.9 ± 13.9 vs 136 ± 7.1, p = 0.0001, I ; 145 ± 20.4 vs 123.9 ± 9.9 mmHg, p < 0.0001), diastolic blood pressure (DBP) ( C ; + 4, p = 0.03, I ; − 7 mmHg, p < 0.0001), cholesterol ( C ; 235.8 ± 57.7 vs 220.9 ± 53.2, p = 0.15, I ; 224 ± 55.2 vs 153 ± 25.9 mg/dL, p < 0.0001), triglycerides ( C ; 213.2 ± 86.6 vs 172.4 ± 48.7, p = 0.001, I ; 273 ± 119.4 vs 143 ± 31.6 mg/dL, p < 0.0001) and estimated glomerular filtration rate (eGFR) ( C ; 77.5 ± 18.6 vs 76 ± 14.2, p = 0.5, I ; 69.4 ± 21.3 vs 93.8 ± 15.2 ml/min/1.73m 2 , p < 0.0001). Likewise, inter-group improvements were more significant in the subjects of intervention group at final follow up in comparison to control for various process outcome measures; HbA1c ( p < 0.001), SBP ( p < 0.0001), DBP ( p = 0.02), cholesterol ( p < 0.0001), triglycerides ( p < 0.0001), SCr ( p < 0.001), eGFR ( p ...
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