Pharmacist-Led Interventions on Improving Outcomes in Patients with Diabetes Mellitus: Evidence from the Literature

Diabetes mellitus is a rapidly growing major health problem world-wide. The management of type 2 diabetes mellitus is complex, requiring continuous medical care by health care professionals and considerable self-care efforts by patients. A collaborative and integrated team approach in which pharmacists can play a pivotal role should be sought when managing patients with diabetes. Pharmacist-led care programs have been shown to help patients with diabetes succeed in achieving treatment goals and improving outcomes. Hence, the aim of this narrative review is to address and summarize the effectiveness of pharmacist interventions in the management of diabetic patients. A comprehensive literature search was conducted in PubMed/Medline, Scopus, web of Science and the Cochrane Library were searched from the date of database inception to June 2019. All randomized controlled trials evaluating the effectiveness of pharmacist-based interventions on diabetic patients in comparison with usual care were included in study. Outcomes of interest included short-term and long-term measures such as glycated haemoglobin (HbA1c), and secondary outcomes were blood glucose level, blood pressure (BP), lipid profile, body mass index (BMI), 10-year coronary heart disease (CHD) risk, medication adherence, health related quality of life (HRQoL), and economic outcomes. Twenty-five studies were included in this systematic study. They were heterogeneous in terms of interventions, participants, settings and outcomes. Pharmacist-led self-management interventions included education on diabetes and its complications, medication adherence, lifestyle and education of self-management skills. Few studies even focussed on patients need through a tailored intervention. We found that those who received the pharmacist care had a statistically significant improvement in HbA1C, blood pressure, lipid profile, health-related quality of life, and CHD risk. These results underline the added value of pharmacists in patient-related care.  Hence this review supports the involvement of pharmacists as a member of health- care teams in managing diabetic patients at diverse settings worldwide. Keywords: diabetes, self-management, HbA1C, pharmaceutical care, randomized controlled tria