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Pharmacist-led medication therapy management improves adherence and glycemic control in a patient with complex T2DMPharmacist-led care improves blood sugar for woman with long-term diabetes

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Key Takeaway
Note that pharmacist-led MTM may improve adherence and glucose levels, but results are limited to a single case.

This case report describes a 76-year-old female with a 30-year history of type 2 diabetes, hypertension, and hyperlipidemia who participated in a pharmacist-led medication therapy management (MTM) program. The intervention included a full medication review, patient education, systematic monitoring, and an optimized treatment plan over a 3-month follow-up period.

The primary outcome was improved medication adherence, with the Medication Adherence Report Scale-5 (MARS-5) increasing from 8 to 21. Secondary outcomes showed improvement in glycemic control, including fasting blood glucose of 7.6 mmol/L, postprandial glucose of 10.2 mmol/L, and an HbA1c of 7.3%. No severe hypoglycemic events or other adverse drug reactions were reported.

A significant limitation is the single patient sample size, which means these results do not establish causation or generalizability to broader populations with complex T2DM regimens. While the intervention showed promise for this individual, the evidence level is low.

How this fits prior evidence

This case report addresses a gap in clinical management by demonstrating how pharmacist-led MTM can improve medication adherence and glycemic control in patients with complex conditions. This finding extends upon previous evidence showing that pharmacist-integrated collaborative outpatient care reduces systolic blood pressure by 7.11 mm Hg in CKM populations.

Managing Type 2 Diabetes for decades can be overwhelming, especially when dealing with complex medications. A 76-year-old woman living with the condition for 30 years faced these challenges until she received specialized pharmacist-led medication therapy management. This involved a full review of her medicines, personalized education, and consistent monitoring of her blood glucose.

After three months of this focused care, her ability to stick to her treatment plan improved significantly. Her adherence score jumped from 8 to 21 on a standard scale. During this same period, her lab results showed improvement, including a fasting blood glucose of 7.6 mmol/L and an HbA1c level of 7.3%.

While these results are encouraging, it is important to note that this was a single case report. Because the study followed only one patient, we cannot know if these exact results would happen for everyone with Type 2 Diabetes. However, it highlights how a pharmacist's expertise can help patients manage complex routines safely.

What this means for you:
Pharmacist-led medication management helped a long-term diabetic patient improve her adherence and blood sugar levels.

Common questions

How did the pharmacist help the patient?

The pharmacist provided medication therapy management. This included a full review of her medications, teaching her about her treatment, and creating an optimized plan. They also worked on systematic monitoring of her blood glucose levels to ensure she stayed on track with her health goals.

Did the patient experience any side effects?

No adverse events or serious reactions were reported during the three-month follow-up. The patient did not experience any severe low blood sugar events (hypoglycemia) or other drug reactions while undergoing the pharmacist-led program.

How much did her blood sugar improve?

After three months, her fasting blood glucose was 7.6 mmol/L and her postprandial (after-meal) glucose was 10.2 mmol/L. Her HbA1c, which measures average blood sugar over time, improved to 7.3%.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
BackgroundPoor medication adherence is a major challenge in healthcare for patients with type 2 diabetes mellitus (T2DM), particularly those with long disease duration, multiple comorbidities, and complex therapeutic regimens. This case report describes the application of pharmacist-led MTM (medication therapy management) in a patient with T2DM presenting complex therapeutic regimens and poor adherence.Patients and methodsA 76-year-old female with a 30-year history of T2DM complicated by diabetic peripheral neuropathy, hypertension, hyperlipidemia, hepatic steatosis, coronary atherosclerosis, and severe osteoporosis. The patient presented with poor glycemic control and severe medication nonadherence, which was characterized by frequent missed doses, irregular glucose monitoring, and forgotten weekly semaglutide injections. A clinical pharmacist conducted comprehensive MTM, including a full medication review, patient education, systematic medication and blood glucose monitoring, development of an optimized treatment plan in collaboration with the medical team, and ongoing follow-up.ResultsAfter 3 months, glycemic control improved significantly, with fasting blood glucose at 7.6 mmol/L, postprandial glucose at 10.2 mmol/L, and glycated hemoglobin (HbA1c) at 7.3%. The Medication Adherence Report Scale-5 (MARS-5) score increased from 8 to 21, and no severe hypoglycemic events or other adverse drug reactions occurred during hospitalization or follow-up.ConclusionImprovements in medication adherence and clinical outcomes were achieved following comprehensive pharmacist-led medication therapy management integrated with individualized clinical management in this case.
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