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. 2010 Oct;8(4):250-4.
doi: 10.4321/s1886-36552010000400008. Epub 2010 Mar 15.

Evaluation of a pharmacist-managed diabetes medication therapy adherence clinic

Phei Ching Lim  1 , Kelvin Lim  2
Affiliations

Evaluation of a pharmacist-managed diabetes medication therapy adherence clinic

Phei Ching Lim et al. Pharm Pract (Granada). 2010 Oct.

Abstract

Patient adherence to prescribed medication regimens is important in diabetes care to prevent or delay microvascular and macrovascular complications such as retinopathy, nephropathy and myocardial infarction. In Penang Hospital, Malaysia, pharmacists collaborate with physicians in diabetes care through a pharmacist-managed Diabetes Medication Therapy Adherence Clinic (DMTAC) in the Endocrine Clinic, in operation since 2006.

Objective: To evaluate the effectiveness of the pharmacist-managed DMTAC program in improving glycaemic control, lipid parameters and patients' medication adherence.

Method: A retrospective study among patients enrolled in the DMTAC program was conducted between September 2007 and December 2008. Data was included from patients with a glycosylated haemoglobin (HbA1c) >8% and who had completed eight visits with the pharmacists. Medical records and DMTAC forms that provided patients' demographics, medication regimens, adherence and laboratory parameters as well as pharmacists' interventions were reviewed. HbA1c, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL), triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were evaluated. Documented data of patients' adherence to medication regimen [Modified Morisky Medication Adherence Score (MMMAS); high adherence if score >8, medium adherence if score 6 to <8 and low adherence if score <6] was also evaluated.

Results: A total of 43 patients (53.5% females; 46.5% Malays, 44.2% Chinese and 9.3% Indians) were included in the analysis. A mean reduction in HbA1c of 1.73% (p<0.001), mean reduction in FBG of 2.65mmol/l (p=0.01) and mean reduction in LDL cholesterol of 0.38mmol/l (p=0.007) were achieved. The difference in TG and HDL cholesterol were not significant. Patients' adherence to medication regimens improved significantly with an increase in the mean MMMAS score from 7.00 to 10.84 (p<0.001) after completion of the DMTAC program.

Conclusion: The pharmacist-managed DMTAC program resulted in significant improvements in HbA1c, glucose and LDL cholesterol levels as well as medication adherence in patients with diabetes.

Keywords: Diabetes; Malaysia; Medication Adherence; Pharmacists.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors have no financial or other conflict of interests that could inappropriately influence or bias the authors’ decision in relation to the manuscript submitted. No sponsorship or funding.

Figures

Figure 1
Figure 1
Use of oral hypoglycaemic agents.
Figure 2
Figure 2
Intervention completed by DMTAC pharmacists. *OHA= oral hypoglycaemic agent
Figure 3
Figure 3
Percentage of Patients with a specified reduction in HBA1c
See this image and copyright information in PMC

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