Impact of a Pharmacist-Led Multidimensional Advisory Intervention on Cardiometabolic Outcomes in Patients With Type 2 Diabetes Mellitus: A Quasi-Experimental Study
2026· Quality of Life (Banja Luka) - APEIRON· 0 citations
TL;DR
Preliminary evidence that pharmacist-led advisory interventions may improve metabolic control in patients with T2DM is provided.
Abstract
Introduction: Type 2 diabetes mellitus (T2DM) is a major public health challenge, particularly in settings where pharmacists remain primarily dispensing-oriented. This study evaluated the impact of a pharmacist-led multidimensional advisory intervention on cardiometabolic outcomes in patients with T2DM. Methodology: A quasi-experimental study with control and intervention groups was conducted in a community pharmacy in Bosnia and Herzegovina. Forty adult patients were allocated to usual care (n=20) or a four-month pharmacist-led programme including nutrition education, lifestyle counselling, physical activity, and continuous support (n=20). Body mass index (BMI), fasting blood glucose (FBG), and blood pressure were measured at baseline and follow-up, while HbA1c was assessed in the intervention group, limiting between-group comparisons. Results: Significant reductions in BMI (p=0.002), FBG (p=0.026), and HbA1c (p=0.001) were observed in the intervention group, whereas no significant improvements were detected in the control group. Conclusion: These findings provide preliminary evidence that pharmacist-led advisory interventions may improve metabolic control in patients with T2DM.
The rising prevalence of type 2 diabetes mellitus (T2DM) has increased complications, particularly in low-income countries. Non-adherence to medication significantly contributes to vascular issues, but pharmacist-led interventions can improve health outcomes and quality of life. Objectives: This study investigated the impact of clinical pharmacist-led interventions on medication adherence and quality of life among T2DM patients. Methods: A retrospective cohort study was conducted at a hospital endocrine clinic. Participants (n=106) were divided into cohorts with and without a history of pharmacist intervention. Quality of life and adherence were assessed using the SF-36 questionnaire and MMAS-8 scale, respectively. Data analysis employed paired t-tests via SPSS version 22, with significance set at p < 0.005. Results: Of the 106 participants, 55 (52%) had received pharmacist interventions. Statistically significant differences (p < 0.001) were observed between groups. The intervention cohort demonstrated significantly higher medication adherence and superior quality of life compared to the non-intervention group. Conclusion: Incorporating pharmacist-led interventions into T2DM management is crucial for improving patient adherence and life expectancy. Healthcare systems should prioritize multidisciplinary collaboration for chronic disease management, particularly in resource-limited settings, to optimize therapeutic outcomes.
Gloria Nnadwa Alhassan, Turgay Karalinç, Blessing Asabe Philip· Aposta: Revista de Ciencias...· 0 citations
The study observed reductions in glycaemic parameters after a nutrition promotion intervention in regulating the blood glucose levels among T2DM patients and supported the importance and effect of customised nutrition counselling and health education in diabetes management to improve glycaemic control.
A. F. Fahhima, I. P. Kumar, B. Nisha· Journal of Clinical and Diag...· 0 citations
INTRODUCTION
According to real-time data from Gujarat, which has the third highest score in the country nationally (7.55%), shows that behavioral, psychological, and economic stressors are associated with elevating HbA1c levels. The current investigation of multifaceted connection within the educational pharmaceutical care interventional program (EPCIP) timeline provides important information about regional causes of inadequate glycaemic control and aids in the development of tailored diabetes management strategies.
OBJECTIVE
The primary objective of this study was to examine the association between longitudinal variations in HbA1c and a structured hospital-based EPCIP delivered by clinical pharmacists. In addition, secondary objective was focused on behavioral, medication adherence, psychological, and economic characteristics of patients in the control group (n = 139) and intervention group (n = 141) across five visits conducted in Gujarat, India.
METHODOLOGY
A randomized, parallel‑group trial was conducted at the Saarathi Institute of Diabetes Sciences, Anand, India, enrolling 280 patients with type 2 diabetes mellitus aged 18-75 years. Eligible participants (HbA1c > 7%, on oral hypoglycemic agents and/or insulin therapy) were recruited and allocated into control (n = 139) and intervention (n = 141) groups using adaptive randomization minimization. The intervention comprised a structured patient‑education framework focusing on self‑management and adherence. Over a 16‑month period (64 weeks), patients in the intervention group attended one educational and one discussion session at each follow‑up (0, 4, 8, 12, and 16 months). Associations between HbA1c and behavioral outcomes (Knowledge, Attitude, Practice [KAP] questionnaire), adherence (Morisky Medication Adherence Scale [MMAS‑8]), psychosocial outcomes (Diabetes Distress Scale [DDS‑17], WHOQOL‑BREF), and economic outcomes (Cost of Illness Questionnaire [COIQ]) were analyzed using regression models to estimate linear relationships across visits between groups.
RESULTS
The EPCIP intervention group showed progressively stronger longitudinal correlations in HbA1c stability (r = 0.74 to 0.89, p=0.000), surpassing the control group (r = 0.62 to 0.74). At Visit 5, significant correlations were observed between HbA1c and indirect cost (r = 0.160, p = 0.022), and medication adherence (MMAS: r = -0.243, p = < 0.001). Total KAP scores maintained consistent negative correlations (r = -0.042, p=0.030), while emotional (r = 0.141, p = 0.044) and physician-related distress (r = 0.593, p < 0.001) notably decreased. Regimen distress normalized (r = -0.019, p = 0.792). Quality of life scores improved post-intervention across physical (r = -0.078, p = 0.006), psychological (r = -0.033, p = 0.047), social (r = -0.047, p = 0.005), and environmental domains (r = -0.113, p = 0.001), indicating EPCIP's multidimensional impact.
CONCLUSION
Stronger longitudinal HbA1c correlations and increased MMAS scores demonstrated the significant improvements in glycaemic stability and behavioural adherence brought about by the EPCIP intervention. Multidimensional psychosocial improvement is reflected in the consistent inverse relationships between overall KAP and decreases in diabetes-related distress domains (DDS17). EPCIP's holistic impact is shown by post-intervention gains across WHOQOL-BREF domains, confirming its validity as a patient-centred approach to long-term diabetes care.
CLINICAL TRIAL NUMBER
Present clinical trial registered with clinical trial registry of India and national institute of medical statistics.
CTRI NUMBER
CTRI/2024/05/067435, Date of Registration:15/05/2024. URL: https://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1%26;compid=19%26;EncHid=12771.59772https://ctri.nic.in/Clinicaltrials/rmaindet.phptrialid=103273%26;EncHid=42604.82156%26;modid=1%26;compid=19.
R. Patel, Harsha V. Patel, Alpa Gor· BMC Endocrine Disorders· 0 citations
Participation in a three-month multicomponent lifestyle intervention was associated with greater improvements in dietary habits, physical activity, glycemic control, lipid profile, and anthropometric indicators compared with usual care among adults with type 2 diabetes mellitus in the Peruvian Amazon.
Mónica Yenji Chia Sánchez, Alexander Javier Iman Torres, Wilson Guerra Sangama et al.· Nutrients· 0 citations
Objective To evaluate the association between a clinical pharmacist-led multimodal remote medication intervention and glycemic control, insulin resistance and estimated β-cell function, medication adherence, and individualized treatment outcomes among patients with type 2 diabetes mellitus (T2DM). Methods A single-center, retrospective, controlled study design was used. A total of 163 patients with T2DM treated in the Endocrinology Department of our hospital between January 2022 and December 2024 were included and allocated, according to the type of pharmaceutical service actually received, to an intervention group (IG, n=85; electronic medical records confirmed receipt of a multimodal remote medication intervention) or a control group (CG, n=78; standard pharmaceutical care). Glycemic indices (HbA1c, FPG, 2hPG), lipid profile and blood pressure, HOMA-IR, HOMA-β, MMAS-8 score, individualized target-attainment rates, and adverse drug reaction data were extracted from the electronic medical record system at baseline and 6 months after intervention, and subgroup analyses were performed according to age, insulin use, and baseline medication adherence. Analysis of covariance (ANCOVA), 1:1 nearest-neighbor propensity score matching, inverse probability of treatment weighting, and Bonferroni correction were used to evaluate the robustness of the findings; subgroup analyses were exploratory. Results Baseline characteristics were comparable between the two groups (all P>0.05). After intervention, HbA1c, FPG, and 2hPG were all significantly lower in the IG than in the CG (all P<0.001; ANCOVA-adjusted between-group differences: HbA1c −0.72%, FPG −0.96 mmol/L, 2hPG −1.59 mmol/L). TC, TG, LDL-C, SBP, and DBP were all significantly lower, and HDL-C significantly higher, in the IG (all P<0.05). HOMA-IR was significantly lower and HOMA-β significantly higher in the IG (both P<0.001). MMAS-8 scores and the proportion of patients with high adherence were significantly greater in the IG (P<0.001). HbA1c attainment, LDL-C attainment, and composite triple-target attainment rates were all higher in the IG (all P<0.01). The overall incidence of adverse drug reaction events was lower in the IG (P<0.05). Exploratory subgroup analyses showed that, within strata defined by age, insulin use, and baseline adherence, the direction of between-group differences in the primary outcomes was generally consistent. Results of the PSM cohort (n=59 pairs) and the IPTW sensitivity analysis were directionally consistent with the primary analysis. Conclusion In this single-center retrospective study, a clinical pharmacist-led multimodal remote medication intervention was associated with more favorable glycemic and cardiometabolic indices, lower HOMA-IR, higher estimated HOMA-β, higher medication adherence, and higher attainment of individualized treatment targets. Because of the non-randomized, observational design, and because HOMA indices are indirect surrogate markers, these associations do not establish causality, the independent contribution of any single intervention component, or recovery of β-cell function.
Yuanfen Zhou, Xin Liu, Kaifeng Tang et al.· Frontiers in Endocrinology· 0 citations
This study aims to evaluate the impact of a pharmacist-led educational intervention on clinical outcomes, medication adherence, and health-related quality of life (HRQoL) of Type 2 diabetes comorbid hypertensive patients. Ninety-two participants were block-randomized into control (
n
= 46, usual care) and intervention (
n
= 46, pharmacist-led education and counseling) groups. Clinical parameters, medication adherence, and HRQoL were assessed at baseline, 3 months, and 6 months. Repeated measures tests and bivariate statistics were used to analyze within-group and between-group differences of outcomes. Seventy-two patients (37 intervention, 35 control) completed the study. The intervention group demonstrated significant reductions in mean glycated hemoglobin (HbA1c) level, systolic and diastolic blood pressure over 6 months (
p
< 0.05), while no significant differences in outcomes were observed among the control group. Altogether, 67.6% of participants in the intervention group attained HbA1c < 7%, and 83.8% achieved optimal blood pressure control and adherence to the prescribed medications. HRQoL health utility score shows marginal but significant improvement in the intervention group. Overall, the pharmacist intervention exhibited small to moderate effects in improving most of these outcomes compared to usual care. The findings revealed that pharmacist-led educational interventions significantly improve clinical outcomes, medication adherence, and HRQoL in diabetic-hypertensive patients. The study recommends routine integration of pharmacists in clinical settings for multidisciplinary care of diabetic-hypertensive patients.
P. Dahal, K. Lakshmi, Kadir Alam· Journal of Applied Pharmaceu...· 0 citations
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