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Pharm Pract (Granada). 2017 Jul-Sep;15(3):1026. doi: 10.18549/PharmPract.2017.03.1026. Epub 2017 Aug 26.

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

Author information

1
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar. Gondar (Ethiopia). staymotivated015@gmail.com.
2
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar. Gondar (Ethiopia). asnake.21.uog@gmail.com.
3
Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar. Gondar (Ethiopia). abeyohannes21@gmail.com.
4
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar. Gondar (Ethiopia). sewunet.admasu@gmail.com.
5
Associate Professor and Director of Drug Information Services School of Pharmacy, College of Pharmacy, Nursing, and Allied Health Sciences, Howard University. Washington, DC (United States). bhailemeskel@howard.edu.
6
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar. Gondar (Ethiopia). heniget@gmail.com.

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.

KEYWORDS:

Diabetes Mellitus; Ethiopia; Medication Adherence; Medication Therapy Management; Patient Education as Topic; Pharmacists; Treatment Outcome; Type 2

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