Pharmaceutical care improves medication adherence and quality of life in type 2 diabetes mellitus

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Angélica Marchesi Lira-Meriguete
Mayara Paes Santos
Viviam Cerqueira de Souza Viana
Nadmy Arrivabene Zavaris Gonçalves
Francine Costa Pereira
Lorena Rocha Ayres
Daniela Amorim Guimaraes do Bem
Rita de Cassia Ribeiro Gonçalves


pharmaceutical care, cardiovascular risk, medication adherence, quality of life


Aims: This study aimed to evaluate whether pharmacotherapeutic follow-up in patients with T2DM in primary care interferes in metabolic control, cardiovascular risk, medication adherence and quality of life. Methods: A prospective clinical study was conducted at two Primary Health Units in Vitória, Espírito Santo, Brazil with 75 patients with T2DM between 40 and 70 years old. The parameters of metabolic control evaluated included fasting blood glucose, HbA1c, triglyceride/HDL-c and total cholesterol/HDL-c ratio. The cardiovascular risk was calculated based on the Framingham risk score. Adherence to medication was measured using the Brief Medication Questionnaire and quality of life was evaluated by applying the World Health Organization Quality of Life-Bref. Results: After the follow-up, there was a significant decreasing in cardiovascular risk (p=0.048) and total cholesterol/HDL-c ratio (p=0.024) and a discrete improvement in fast glucose and HbA1c levels. The quality of life scores increased for all domains (p<0.0001) and the treatment adherence also improved with 12.00% of the patients classified as low adherence in the final time, against 41.33% before the meetings. Conclusion: These results show the proposed pharmacotherapeutic follow-up influenced positively cardiovascular risk, adherence to therapy and quality of life in all domains, and, therefore, may contribute to delay the onset of the main chronic complications of the disease.

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1. PAHO, Pan American Health Organization, World Health Organization. Noncommunicable dieseases; [cited 2023 Apr 10]. Available from:
2. Roden M, Shulman GI. The integrative biology of type 2 diabetes. Nature. 2019;576:51-60. 019-1797-8.
3. Mendes ABV, Fittipaldi JAS, Neves RCS, et al. Prevalence and correlates of inadequate glycaemic control: Results from a nationwide survey in 6,671 adults with diabetes in Brazil. Acta Diabetol. 2010;47:137-145. 0090138-z
4. Galicia-Garcia U, Benito-Vicente A, Jebari S, et al. Pathophysiology of Type 2 Diabetes Mellitus. Int J Mol Sci. 2020;(17):6275.
5. Einarson TR, Acs A, Ludwig C, et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17(1):83. 0180728-6
6. McLellan KCP, Barbalho SM, Cattalini M, et al. Diabetes mellitus do tipo 2, síndrome metabólica e modificação no estilo de vida. Rev Nutr. 2007;20:515-524.
7. Palamenghi L, Carlucci MM, Graffigna, G. Measuring the Quality of Life in Diabetic Patients: A Scoping Review, Journal of Diabetes Research. 2020;19.
8. Davies MJ, D’Alessio DA, Fradkin J, et al Management of Hyperglycemia in Type 2 Diabetes, 2018; Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669-2701.
9. Reach G, Pechtner V, Gentilella R, et al. Clinical inertia and its impact on treatment intensification in people with type 2 diabetes mellitus. Diabetes Metab. 2017;43:501-511.
10. Mourão AOM, Ferreira WR, Martins MAP, et al. Pharmaceutical care program for type 2 diabetes patients in Brazil: A randomised controlled trial. Int J Clin Pharm. 2013;35:79-86.
11. Nogueira M, Otuyama LJ, Rocha PA, et al. Pharmaceutical care-based interventions in type 2 diabetes mellitus : a systematic review and meta-analysis of randomized clinical trials. Einstein. 2020;18:eRW4686. journal/2020RW4686
12. Brasil, Ministério da Saúde, Secretaria de Ciência, et al. Departamento de Assistência Farmacêutica e Insumos. Capacitação para implantação dos serviços de clínica farmacêutica, Brasília. 2014.
13. Ben AJ, Neumann CR, Mengue SS. The brief medication questionnaire and MoriskyGreen test to evaluate medication adherence. Rev Saude Publica. 2012;46:279-289.
14. Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data Data for Categorical of Observer Agreement the Measurement. Int Biometric Soc. 1977;13:159-174.
15. Huang J, Ding S, Xiong S, et al. Medication Adherence and Associated Factors in Patients with Type 2 Diabetes: A Structural Equation Model. Front Public Health. 2021;9:730845.
16. Correr CJ, Pontarolo R, de P. e Souza RA, et al. Effect of a pharmaceutical care program on quality of life and satisfaction with pharmacy services in patients with type 2 diabetes mellitus. Braz J Pharm Sci. 2009;45:809-817. s1984-82502009000400027
17. Sriram S, Chack LE, Ramasamy R, et al. Impact of pharmaceutical care on quality of life in patients with type 2 diabetes mellitus. J Res Med Sci. 2011;16:412-418.
18. Adibe MO, Ukwe CV, Aguwa CN. The Impact of Pharmaceutical Care Intervention on the Quality of Life of Nigerian Patients Receiving Treatment for Type 2 Diabetes, Value Heal. Reg. 2013;2:240-247.
19. Marinho FS, Moram CBM, Rodrigues PC, et al. Treatment Adherence and Its Associated Factors in Patients with Type 2 Diabetes:Results from the Rio de Janeiro Type 2 Diabetes Cohort Study. J Diabetes Res. 2018;27.
20. Miyauchi M, Toyoda M, Kaneyama N, et al.Exercise Therapy for Management of Type 2 Diabetes Mellitus: Superior Efficacy of Activity Monitors over Pedometers, Journal of Diabetes Research. 2016;7.
21. Zhang P, Wang J, Gregg EW, et al. The longterm effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study, Lancet. 2008;271:1783-1789.
22. Omaran D, Majumdar SR, Johnson JA, et al. Pharmacists on primary care teams: Effect on antihypertensive medication management in patients with type 2 diabetes. Journal of the American Pharmacists Association. 2015;55(3):265-8. https://
23. Odegard PS, Goo A, Hummel J, et al. Caring for poorly controlled diabetes mellitus: A randomized pharmacist intervention. Ann Pharmacother 2005;39:433-440.
24. Wilson PWF, D’Agostinho RB, Levy D, et al. Prediction of Coronary Heart Disease Using Risk Factor Categories. Circulation. 1998;97:1837-1847.
25. Neto PRO, Marusic S, de Lyra Júnior DP, et al. Effect of a 36-month pharmaceutical care program on the coronary heart disease risk in elderly diabetic and hypertensive patients. J Pharm Pharm Sci. 2011;14:249-63.
26. Fahs I, Hallit S, Rahal M, et al. The community pharmacist’s role in reducing CVD risk factors in Lebanon: a cross-sectional longitudinal study. Med Princ Pr. 2018;1-7.
27. Plaster CP, Melo DT, Boldt V, et al. Reduction of cardiovascular risk in patients with metabolic syndrome in a community health center after a pharmaceutical care program of pharmacotherapy follow-up Camila. Brazilian J Pharm Sci. 2012; 48:435-446.
28. Tavares NUL, Bertoldi AD, Thumé E, et al. Fatores associados à baixa adesão ao tratamento medicamentoso em idosos Factors associated with low adherence to medication in older adults. Rev Saude Publica. 2013;47:1092-1101. S0034-8910.2013047004834
29. World Health Organization (WHO), Adherence to long-term therapies: Evidence for action. Eur J Cardiovasc Nurs. 2003;2:323.
30. Tavares NUL, Bertoldi AD, Mengue SS, et al. Factors associated with low adherence to medicine treatment for chronic diseases in brazil. Rev Saude Publica. 50 (2016).
31. Ojieabu WA, Bello SI, Arute JE. Glucose Monitoring Technologies - Complementary or Competitive? Role of Continuous Glucose Monitoring versus Flash Glucose Monitoring versus Self-monitoring of Blood Glucose. J Diabetol. 2017;8:61-67. https://doi. org/10.4103/jod.jod
32. * OPAS, - Organização Pan-Americana de Saúde. Consenso Brasileiro de Atenção Farmacêutica: proposta / Adriana Mitsue Ivama... [et al.], Brasília, 2002. 94312-X
33. Souza TT, Santini L, Wada SA, et al. Qualidade de vida da pessoa diabetica. Rev Esc Enferm. USP. 1997;150-64. https://doi. org/10.1590/S008062341997000100012
34. Fleck MP, Louzada S, Xavier M, et al. Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Rev Saude Publica. 2000;34:178-183.
35. Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World J Diabetes. 2017;8:120-171. https://
36. Milanovic Z, Pantelic S, Trajkovic N, et al. Age-related decrease in physical activity and functional fitness among elderly men and women. Clin Interv Aging. 2013;8:549-556.

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