title: Assessing the effectiveness of pharmacist-directed medication therapy management in improving diabetes outcomes in patients with poorly controlled diabetes.
abstract: The purpose of this study was to compare medication adherence rates and type 2 diabetes mellitus (T2DM) health outcomes in a sample of underserved patients with suboptimally controlled T2DM (A1C >7%) who had received pharmacist-directed medication therapy management (MTM) to those who had not received MTM.
  
  
  
  A retrospective review of 100 patient records was conducted. For the MTM group, a pharmacist engaged patients in patient-centered services to optimize therapeutic outcomes. Non-MTM patients received usual care. Outcomes were A1C, medication adherence, blood pressure, lipids, and creatinine. Group comparisons on clinical outcomes were analyzed before and after matching MTM and non-MTM patients on demographic characteristics.
  
  
  
  Before matching, the MTM group had a higher rate of medication adherence than the non-MTM group. The A1C levels were lower in the MTM group compared to the non-MTM group. Similarly, low-density lipoprotein (LDL) cholesterol was lower in the MTM group compared to the non-MTM group. After matching, medication adherence rate remained higher in the MTM group than the non-MTM group. Similarly, A1C levels remained lower in the MTM group than the non-MTM group.
  
  
  
  There is a paucity of research focused on behavioral interventions for improving health outcomes in underserved communities. Our results advance the existing literature by demonstrating a positive association between pharmacist-directed MTM, medication adherence, and glycemic control in a sample of underserved patients with suboptimally controlled T2DM. A prospective pharmacy intervention and examination of long-term effects of MTM on medication adherence and T2DM health outcomes in this population is warranted.
authors.affiliation: Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Skinner, Mr Poe, Dr Boyer, Dr Wilkins)
authors.forename: Jeannine S
authors.initials: JS
authors.lastname: Skinner
authors.affiliation: Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Skinner, Mr Poe, Dr Boyer, Dr Wilkins)
authors.forename: Brett
authors.initials: B
authors.lastname: Poe
authors.affiliation: Saint Thomas Family Center, West, Nashville, Tennessee (Dr Hopper)
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hopper
authors.affiliation: Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Skinner, Mr Poe, Dr Boyer, Dr Wilkins)
authors.forename: Alaina
authors.initials: A
authors.lastname: Boyer
authors.affiliation: Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Skinner, Mr Poe, Dr Boyer, Dr Wilkins)|Meharry Medical College, Nashville, Tennessee (Dr Wilkins)
authors.forename: Consuelo H
authors.initials: CH
authors.lastname: Wilkins
mesh_terms: D000368:Aged; D001794:Blood Pressure; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008055:Lipids / Q000097:blood; D008297:Male; D055118:Medication Adherence; D054539:Medication Therapy Management; D008875:Middle Aged; D010593:Pharmaceutical Services; D010595:Pharmacists; D015397:Program Evaluation; D012189:Retrospective Studies
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008055:Lipids; C517652:hemoglobin A1c protein, human