Summary: In 400 adults with diabetes randomised to a one-year trial, pharmacist-led collaborative care delivered through hospital DMTAC clinics was associated with greater improvement in EQ-5D quality of life (VAS 54.45 to 72.23 vs 55.89 to 64.86; F(1,292)=118.67, p<0.001) and a larger fall in HbA1c (2.84% vs 1.44%; p<0.05) than routine care alone. All EQ-5D domains improved significantly in the intervention arm.
PICO Summary
| Element | Detail |
|---|---|
| Population | 400 adults with diabetes recruited from hospitals; randomised, two-arm, one-year trial with two follow-up visits. |
| Intervention | Pharmacist-led educational and collaborative care via Diabetes Medication Therapy Adherence Clinics (DMTAC) plus routine management (n=200). |
| Comparison | Routine hospital diabetic care without pharmacist intervention (n=200). |
| Outcome | HbA1c fell by 2.84% (intervention) vs 1.44% (control); within-arm improvement significant at p<0.05 (no between-group effect size or 95% CI reported). EQ-5D VAS rose 54.45 plus/minus 8.81 to 72.23 plus/minus 6.41 (intervention) vs 55.89 plus/minus 7.52 to 64.86 plus/minus 5.04 (control); F(1,292)=118.67, p<0.001. All EQ-5D domains improved significantly (p<0.05). Adverse events were not reported. |
Pharmacist-led care in diabetes
RCT · type 2 diabetes · 1 year
Pharmacist-led DMTAC care improved EQ-5D quality of life and lowered HbA1c more than routine care over one year, but the open-label design and within-arm-only HbA1c reporting mean the true between-group benefit is uncertain.
Expert Commentary
This randomised controlled trial supports a now-familiar verdict: structured pharmacist-led collaborative care, embedded here within hospital adherence clinics, is associated with better patient-reported quality of life and tighter glycaemia than routine care over one year. The EQ-5D visual analogue scale difference is large and was tested with an analysis of variance reaching p<0.001, and every EQ-5D domain moved favourably in the intervention arm. The reported HbA1c reductions, however, warrant caution. A 2.84 percentage-point within-arm fall is implausibly large for a behavioural intervention, the abstract presents within-group changes rather than a between-group treatment effect, and no 95 percent confidence interval, absolute risk reduction, or number needed to treat is provided, so the true incremental benefit over routine care cannot be quantified from these data. The dominant limitation is that an educational intervention of this kind cannot be blinded, leaving the open-label design vulnerable to expectation and reporting bias on a subjective quality-of-life outcome. Adverse events were not described. Can I use this with my patients? Cautiously, yes for the care model: referring motivated adults with suboptimally controlled diabetes to a pharmacist-led adherence clinic is reasonable and low-risk, but the specific magnitude of HbA1c benefit should not be quoted to patients. Clinicians should look for the full-text effect sizes before treating these figures as settled.
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
