Assessing the effectiveness of pharmacist-directed medication therapy management in improving diabetes outcomes in patients with poorly controlled diabetes

Diabetes Educ. 2015 Aug;41(4):459-65. doi: 10.1177/0145721715587563. Epub 2015 May 25.

Abstract

Purpose: The purpose of this study was to compare medication adherence rates and type 2 diabetes mellitus (T2DM) health outcomes in a sample of underserved patients with suboptimally controlled T2DM (A1C >7%) who had received pharmacist-directed medication therapy management (MTM) to those who had not received MTM.

Methods: A retrospective review of 100 patient records was conducted. For the MTM group, a pharmacist engaged patients in patient-centered services to optimize therapeutic outcomes. Non-MTM patients received usual care. Outcomes were A1C, medication adherence, blood pressure, lipids, and creatinine. Group comparisons on clinical outcomes were analyzed before and after matching MTM and non-MTM patients on demographic characteristics.

Results: Before matching, the MTM group had a higher rate of medication adherence than the non-MTM group. The A1C levels were lower in the MTM group compared to the non-MTM group. Similarly, low-density lipoprotein (LDL) cholesterol was lower in the MTM group compared to the non-MTM group. After matching, medication adherence rate remained higher in the MTM group than the non-MTM group. Similarly, A1C levels remained lower in the MTM group than the non-MTM group.

Conclusions: There is a paucity of research focused on behavioral interventions for improving health outcomes in underserved communities. Our results advance the existing literature by demonstrating a positive association between pharmacist-directed MTM, medication adherence, and glycemic control in a sample of underserved patients with suboptimally controlled T2DM. A prospective pharmacy intervention and examination of long-term effects of MTM on medication adherence and T2DM health outcomes in this population is warranted.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Blood Pressure
  • Case-Control Studies
  • Creatinine / blood
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Lipids / blood
  • Male
  • Medication Adherence
  • Medication Therapy Management*
  • Middle Aged
  • Pharmaceutical Services*
  • Pharmacists
  • Program Evaluation*
  • Retrospective Studies

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Lipids
  • hemoglobin A1c protein, human
  • Creatinine