The impact of pharmacist-led medication therapy management on medication adherence in patients with type 2 diabetes mellitus: a randomized controlled study

Abstract

Background:Poor adherence to antidiabetic medications leads to a higher rate of hospital admissions and adverse health outcomes in type 2 diabetes mellitus patients.Objective:This study aims to evaluate whether a pharmacist-led medication therapy management, compared to the usual care, could enhance medication adherence and reduce hospital admission in patients with type 2 diabetes mellitus.Methods:A prospective randomized controlled study was conducted in patients with type 2 diabetes mellitus from February 1 to July 30, 2016. Patients in the control group (n=65) received the usual care while patients in the intervention group (n=62) received a personalized pharmacotherapeutic care plan and diabetes education. The two groups were compared by repeated measure ANOVA at 3 and 6-months with medication adherence (using Morisky medication adherence scale) and number of hospital admissions as the main outcome variables.Results:A total of 127 patients were included in the study. A marked and statistically significant increase in medication adherence from baseline to 3 and 6 months were noted in the intervention group (increased from 9.2% at baseline to 61% at 6 month) compared with the control group (increased from 13.2% at baseline (to 30.2% at 6 month; p-value<0.01). Furthermore, at the 6-month follow-up, only 23 patients in MTM group with poorly controlled blood glucose levels resulted in hospital admissions compared to 48 patients in non-MTM group, resulting in a 52.1% fewer hospital admissions (p< 0.001).Conclusions:The findings of this study implied that pharmacist-led medication therapy management might improve medication adherence and reduce number of hospitalizations in patients with type 2 diabetes mellitus. Hence, policies and guidelines should be in place in order for clinical pharmacists to fully engage in patient care and improve the medication therapy outcomes.

An assessment of counseling quality provided by community pharmacies to type 2 diabetic adult patients for oral therapy: a simulated patient study from Pakistan

“…Non-adherence to medication by type 2 DPs of Pakistan is common [42]. But several studies proves that pharmacists' intervention can improve adherence to medication of type 2 DM [43,44]. But current study shows that about 59.5% drug sellers highlighted the effect of non-compliance to medication.…”

Knowledge regarding medicines management of type 2 diabetes amongst patients attending a Community Health Centre in South Africa

“…This includes pharmacists and others improving patients' knowledge about their disease, as well as ensuring they have a satisfactory experience when visiting ambulatory care clinics, to improve future medicine use. [50][51][52][53][54][55] Such activities though must take account of the fact that the patient population attending CHCs in South Africa (Table 1) typically have no formal education or only primary education, similar to other ambulatory care settings in South Africa and other African countries. [9,20,24,[56][57][58] Consequently, storytelling and other similar approaches may be appropriate, alongside initiatives such as diaries, pictograms and counselling involving pharmacists, to improve patient knowledge and subsequent medicine use.…”

The Role of Pharmacist in Managing Hypertension in the Community: Findings from a Community Based Study

“…These findings are similar to previous literature demonstrating the impacts of pharmacist led education program to improve medication adherence. 15,44,45 A meta-analysis of randomised control trials conducted by Cheema et al reported that 6 out of 7 studies had significantly increased in medication adherence from 56% to 68% in the intervention groups compare to control groups (Odds ratio 12.1, 95% CI 4.2-34.6; P<0.001). 18 Medication adherence could be improved by understanding to the nature of the disease and the rationale of the medication.…”