Summary: In a 1-year randomised controlled trial of 400 adults with type 2 diabetes, pharmacist-led collaborative care delivered through diabetes medication therapy adherence clinics was associated with significant improvements across all EQ-5D 5L domains and a greater rise in visual analogue scale (VAS) scores than standard care (intervention 54.45 to 72.23 versus control 55.89 to 64.86; ANOVA F[1,292]=118.67, p<0.001). Glycated haemoglobin fell by 2.84% in the intervention arm versus 1.44% with usual care (p<0.05).
PICO Summary
| Element | Detail |
|---|---|
| Population | 400 adults with diabetes recruited from hospital outpatient services and randomised into two equal arms; single-country trial (Saudi Arabia), 1-year duration with two follow-up visits. |
| Intervention | Pharmacist-led collaborative care via diabetes medication therapy adherence clinics (counselling on adherence, diet, exercise and disease management) added to routine diabetic care (n=200). |
| Comparison | Routine hospital diabetic management and treatment without the additional pharmacist-led educational component (n=200). |
| Outcome | VAS improved from 54.45±8.81 to 72.23±6.41 in the intervention arm versus 55.89±7.52 to 64.86±5.04 in controls (ANOVA F[1,292]=118.67, p<0.001); all EQ-5D 5L domains showed significant association with health-related quality of life (p<0.05). HbA1c fell by 2.84% (intervention) versus 1.44% (control), favouring the intervention (p<0.05). The abstract reports within- and between-arm significance but does not provide adjusted between-group effect sizes with 95% confidence intervals, nor ARR/NNT. |
Pharmacist-led care and quality of life in type 2 diabetes
RCT · type 2 diabetes · 1 year
Adding pharmacist-led adherence-clinic care raised EQ-5D VAS quality-of-life scores more than usual care (+17.8 vs +9.0) and roughly doubled the HbA1c reduction (2.84% vs 1.44%). Open-label design and absence of adjusted between-group effect sizes temper certainty.
Expert Commentary
This randomised controlled trial reports that pharmacist-led collaborative care, layered onto routine management, was associated with significant gains in patient-reported quality of life and a larger reduction in glycated haemoglobin than standard care alone. The direction and consistency of effect across all EQ-5D domains, the VAS improvement, and the steeper HbA1c fall are encouraging and biologically plausible, given that structured adherence and lifestyle counselling are established levers in diabetes care. The verdict is cautiously positive but should be read as supportive rather than definitive. The principal limitation is that an educational intervention of this kind cannot be blinded, so the open-label design leaves the quality-of-life findings, which are subjective, vulnerable to expectation and reporting bias; the abstract also presents significance testing without adjusted between-group effect sizes or confidence intervals, which limits precision. The single-country, single-system setting further constrains generalisability. Can I use this with my patients? Tentatively yes, in the sense that referring a motivated adult with type 2 diabetes to a pharmacist-led adherence clinic is low-risk and aligns with existing evidence, while recognising that this particular trial does not by itself prove a durable, transportable benefit. Confirmatory work with blinded outcome assessment, pre-registered endpoints, and reporting of adjusted effect sizes would strengthen the case considerably.
References
Iqbal MZ, Alqahtani SS. Effect of pharmacist led intervention on health related quality of life in diabetic patients assessed using EQ5D domains and visual analogue scale. Sci Rep. 2025;15(1):21222. doi:10.1038/s41598-025-04439-w