Improved Patient-Reported Medication Adherence, Patient Satisfaction, and Glycemic Control in a Collaborative Care Pharmacist-Led Diabetes "Tune-Up" Clinic

Int J Environ Res Public Health. 2021 Sep 1;18(17):9242. doi: 10.3390/ijerph18179242.

Abstract

Diabetes complications remain a leading cause of death, which may be due to poor glycemic control resulting from medication nonadherence. The relationship between adherence status and HbA1c (glycemic control) has not been well-studied for clinical pharmacist interventions. This study evaluated medication adherence, patient satisfaction, and HbA1c, in a collaborative pharmacist-endocrinologist diabetes clinic over 6 months. Of 127 referred, 83 patients met the inclusion criteria. Mean medication adherence scores, considered "good" at baseline, 1.4 ± 1.2, improved by 0.05 points (p = 0.018), and there was a 26% increase in patients with good adherence. A significant improvement of 0.40 percentage points (95% CI: -0.47, -0.34) was observed in mean HbA1c across the three time points (p < 0.001). Mean total satisfaction scores were high and increased, with mean 91.3 ± 12.2 at baseline, 94.7 ± 9.6 at 3 months, and 95.7 ± 10.8 at 6 months (p = 0.009). A multimodal personalized treatment approach from a pharmacist provider significantly and positively impacted glycemic control regardless of self-reported medication adherence, and patient satisfaction remained high despite changing to a clinical pharmacist provider and increased care intensity.

Keywords: collaborative care; diabetes; glycemic control; medication adherence; patient satisfaction; pharmacist; pharmacist–patient relations.

MeSH terms

  • Diabetes Mellitus, Type 2*
  • Glycated Hemoglobin / analysis
  • Glycemic Control
  • Humans
  • Medication Adherence
  • Patient Reported Outcome Measures
  • Patient Satisfaction
  • Pharmacists*

Substances

  • Glycated Hemoglobin A