Evaluating the Effect of Pharmacist's Delivered Counseling on Medication Adherence and Glycemic Control in Patients with Diabetes Mellitus

Introduction: Diabetes mellitus is a metabolic disorder leading to significant morbidity and mortality and negatively affects patient quality of life. Lifestyle modifications and patient medication adherence are the most important factor that contributes to effective management. Objectives: To assess the impact of pharmacist delivered counseling on medication adherence and glycemic control in patients with diabetes mellitus. Method: It was a prospective, interventional study carried over a period of 12 months from October 2014 September 2015 in general medicine outpatient department of a tertiary care teaching hospital. A total of 106 Patients who fulfilled the study criteria were randomized into intervention group (55 patients) and usual care groups (51 patients) were completed the study. Patient information leaflet and medication counseling was provided to intervention group by the clinical pharmacist. Adherence to the treatment has been assessed during a personal interview with each patient in both the groups by using Morisky Medication Adherence Scale at base line and final follow up. In a group of 30 patients in the intervention group glycosylated hemoglobin was recorded at baseline and final follow up. These adherence scores and glycemic levels (fasting plasma glucose and post prandial plasma glucose) were obtained and compared between both groups at the end of the study. Results: At the baseline, there was no significant difference in medication adherence scores and glycemic levels between the usual care and intervention groups (p>0.005). However, statistically significant differences in glycemic levels (fasting plasma glucose and post prandial plasma glucose) and medication adherence scores was observed in the final follow up in intervention group as compared to the usual care group (p<0.005). Conclusion: The study suggests that clinical pharmacist intervention through patient education and medication counseling made a significant influence for improvement in medication adherence and glycemic control in patients with diabetes mellitus.