ArticleJournal of pharmaceutical policy and practice2023
The impact of pharmacist interventions, follow-up frequency and default on glycemic control in Diabetes Medication Therapy Adherence Clinic program: a multicenter study in Malaysia.
Article in Journal of pharmaceutical policy and practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Efficacy of Community-based Interventions in Reducing HbA1c Levels Among Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Recent Studies Conducted in Developing Countries.Journal of primary care & community healthPooled it
- Primary health care interventions targeting diabetes, hypertension or dyslipidemia in Malaysia: A scoping review.PloS one · 2026Article
- Diabetes distress among adults with type 2 diabetes mellitus in the North of West Bank-Palestine.Discover mental health · 2025Article
- Association between follow-up visit frequency, medication types prescribed, and glycaemic outcomes among diabetic patients in China's Basic Public Health Services programme: a retrospective cohort study.BMJ public health · 2025Article
- Impact of Attendance to a Pharmacist-Managed Medication Adherence Clinic on Glycemic Control and Risk Factors for Non-Completion Among Persons with Type 2 Diabetes Mellitus in Selangor, Malaysia.Therapeutics and clinical risk management · 2024Article
- Development and validation of patient diabetes knowledge questionnaire (PDKQ).Journal of pharmaceutical policy and practice · 2023Article
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPharmacist's involvement in optimizing medication adherence among diabetic patients has been implemented for over a decade. Diabetes Medication Therapy Adherence Clinic (DMTAC) was set up to educate diabetic patients, monitor treatment outcomes, and manage drug-related problems. While evidence shows that pharmacist-led DMTAC was effective in reducing HbA1c, there was limited data regarding the impact of different intervention types and default to follow-up on glycemic control.
aimTo assess the impact DMTAC on glycemic control and the difference in glycemic control between hospital and health clinic settings as well as defaulter and non-defaulter. In addition, the impact of pharmacist's interventions, DMTAC follow-up frequencies, and duration of diabetes on glycemic control were also determined.
methodsA retrospective study was conducted among diabetes patients under DMTAC care between January 2019 and June 2020 in five hospitals and 23 primary health clinics. Patients' demographics data, treatment regimens, frequencies of DMTAC visits, defaulter (absent from DMTAC visits) and types of pharmacists' intervention were retrieved from patients' medical records and electronic database. HbA1c was collected at baseline, 4-6 months (post-1), and 8-12 months (post-2).
resultsWe included 956 patients, of which 60% were females with a median age of 58.0 (IQR: 5.0) years. Overall, the HbA1c reduced significantly from baseline (median: 10.2, IQR: 3.0) to post-1 (median: 8.8, IQR: 2.7) and post-2 (median: 8.3, IQR: 2.6%) (p < 0.001). There were 4317 pharmacists' interventions performed, with the majority being dosage adjustment (n = 2407, 55.8%), followed by lab investigations (849, 19.7%), drugs addition (653, 15.1%), drugs discontinuation (408, 9.5%). Patients treated in hospitals received significantly more interventions than those treated in primary health clinics (p < 0.001). We observed significantly less reduction in HbA1c in DMTAC follow-up defaulters than non-defaulters after 1 year (- 1.02% vs. - 2.14%, p = 0.001). Frequencies of DMTAC visits (b: 0.19, CI: 0.079-0.302, p = 0.001), number of dosage adjustments (b: 0.83, CI: 0.015-0.151, p = 0.018) and number of additional drugs recommended (b: 0.37, CI: 0.049-0.691, p = 0.024) had positive impact on glycemic control whereas duration of diabetes (b: - 0.0302, CI: - 0.0507, - 0.007, p = 0.011) had negative impact.
conclusionGlycemic control improved significantly and sustained up to one year among patients in pharmacists-led DMTAC. However, DMTAC defaulters experienced poorer glycemic control. Considering more frequent visits and targeted interventions by pharmacists at DMTAC resulted in improved HbA1c control, these strategies should be taken into account for future program planning.
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