title: Effects of a pharmaceutical care model on medication adherence and glycemic control of people with type 2 diabetes.
abstract: BACKGROUND
  Diabetes mellitus is a lifelong chronic condition that requires self-management. Lifestyle modification and adherence to antidiabetes medications are the major determinants of therapeutic success in the management of diabetes.
  
  
  OBJECTIVE
  To assess the effects of a pharmaceutical care (PC) model on medication adherence and glycemic levels of people with type 2 diabetes mellitus.
  
  
  METHODS
  A total of 241 people with type 2 diabetes were recruited from a major teaching hospital in Malaysia and allocated at random to the control (n=121) or intervention (n=120) groups. Participants in the intervention group received PC from an experienced pharmacist, whereas those in the control group were provided the standard pharmacy service. Medication adherence was assessed using the Malaysian Medication Adherence Scale, and glycemic levels (glycated hemoglobin values and fasting blood glucose [FBG]) of participants were obtained at baseline and after 4, 8, and 12 months.
  
  
  RESULTS
  At baseline, there were no significant differences in demographic data, medication adherence, and glycemic levels between participants in the control and intervention groups. However, statistically significant differences in FBG and glycated hemoglobin values were observed between the control and intervention groups at months 4, 8, and 12 after the provision of PC (median FBG, 9.0 versus 7.2 mmol/L [P<0.001]; median glycated hemoglobin level, 9.1% versus 8.0% [P<0.001] at 12 months). Medication adherence was also significantly associated with the provision of PC, with a higher proportion in the intervention group than in the control group achieving it (75.0% versus 58.7%; P=0.007).
  
  
  CONCLUSIONS
  The provision of PC has positive effects on medication adherence as well as the glycemic control of people with type 2 diabetes. Therefore, the PC model used in this study should be duplicated in other health care settings for the benefit of more patients with type 2 diabetes.
authors.affiliation: Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; Pharmacy Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Wen Wei
authors.initials: WW
authors.lastname: Chung
authors.affiliation: Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Siew Siang
authors.initials: SS
authors.lastname: Chua
authors.affiliation: Department of Primary Care Medicine, University Malaya Primary Care Research Group, Kuala Lumpur, Malaysia.
authors.forename: Pauline Siew Mei
authors.initials: PS
authors.lastname: Lai
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Siew Pheng
authors.initials: SP
authors.lastname: Chan
keywords: glycemic control; medication adherence; pharmaceutical care; type 2 diabetes mellitus