Evaluating the Effect of Pharmacist’s Delivered Counseling on Medication Adherence and Glycemic Control in Patients with Diabetes Mellitus

Abstract

Introduction: Diabetes mellitus is a metabolic disorder leading to significant morbidity and mortality and negatively affects patient quality of life. Lifestyle modifications and patient medication adherence are the most important factor that contributes to effective management. Objectives:To assess the impact of pharmacist delivered counseling on medication adherence and glycemic control in patients with diabetes mellitus. Method:It was a prospective, interventional study carried over a period of 12 months from October 2014 -September 2015 in general medicine outpatient department of a tertiary care teaching hospital. A total of 106 Patients who fulfilled the study criteria were randomized into intervention group (55 patients) and usual care groups (51 patients) were completed the study. Patient information leaflet and medication counseling was provided to intervention group by the clinical pharmacist. Adherence to the treatment has been assessed during a personal interview with each patient in both the groups by using Morisky Medication Adherence Scale at base line and final follow up. In a group of 30 patients in the intervention group glycosylated hemoglobin was recorded at baseline and final follow up. These adherence scores and glycemic levels (fasting plasma glucose and post prandial plasma glucose) were obtained and compared between both groups at the end of the study.Results: At the baseline, there was no significant difference in medication adherence scores and glycemic levels between the usual care and intervention groups (p>0.005). However, statistically significant differences in glycemic levels (fasting plasma glucose and post prandial plasma glucose ) and medication adherence scores was observed in the final follow up in intervention group as compared to the usual care group (p<0.005). Conclusion:The study suggests that clinical pharmacist intervention through patient education and medication counseling made a significant influence for improvement in medication adherence and glycemic control in patients with diabetes mellitus.

Impact of pharmacist-directed counseling and message reminder services on medication adherence and clinical outcomes in type 2 diabetes mellitus

“…These findings are nearly similar to the results of a diabetic study conducted by Shareef et al . [17] Other outcomes such as SBP and LDL-cholesterol are also significantly reduced in the intervention group compared to usual care with a P < 0.01. These findings are consistent with the results of the study conducted by Shao et al .…”

The Effect of Based Services Medication Therapy Management on Treatment Adherence and Quality of Life of Diabetes Mellitus Patients

“…Based on the measurement results, the poor adherence decreased from 48.2% to 26.1%, moderate adherence increased from 32.1% to 39.1% and high adherence increased from 19.7% to 34.9% with significance value of P = 0.000 (<0.05) which indicates that the treatment adherence of DM patients increased significantly after pharmacist intervention 31 . Research conducted by Shareef and Fernandes 32 , and Butt et al, 33 , also showed similar results, in which pharmacist intervention through education, counseling, and monitoring related to disease and DM therapy possess a significant effect in improving treatment adherence to DM patients. Various studies related to the intervention conducted by pharmacists show a good effect on patient 2 , also shows that in addition to providing education and counseling, PMR, MAP, the diabetes calendars and/or leaflets provided as part of the MTM service program are effective in increasing the adherence of patient treatment.…”

What do persons with diabetes want from community pharmacies? A qualitative study

“…It is, however, well documented that community pharmacy service programmes supporting adherence have a significant effect on glycaemic control, improve medication adherence and improve blood pressure. 19 , 55 , 56 Interventions by community pharmacies may therefore to a greater extent help persons with diabetes to self-manage their medication and life with diabetes. 57 However, community pharmacy services are not connected with the rest of the healthcare system.…”