Enhancing Diabetes Management Through Clinical Pharmacist Interventions: A Narrative Review
DOI:
https://doi.org/10.61978/spfki.v1i1.638Keywords:
Clinical Pharmacist, Type 2 Diabetes Mellitus, Interdisciplinary Care, Pharmacist Intervention, Collaborative Drug Therapy, Medication Adherence, Chronic Disease ManagementAbstract
Type 2 Diabetes Mellitus (T2DM) presents an escalating global health challenge, necessitating innovative approaches in chronic disease management. This narrative review critically examines the role of clinical pharmacists in enhancing T2DM care, focusing on their impact on clinical outcomes, patient education, interdisciplinary collaboration, and cost effectiveness. A structured literature search was conducted across PubMed, Scopus, ScienceDirect, and CINAHL databases for studies published between 2010 and 2023. Inclusion criteria targeted peer reviewed articles and empirical research examining pharmacist led interventions in T2DM management. The review identified strong evidence supporting the effectiveness of clinical pharmacists in improving glycemic control, blood pressure, lipid profiles, and patient adherence. Interventions such as therapeutic regimen adjustments, counseling, and promotion of self-monitoring significantly improved patient outcomes and reduced hospitalization rates. Collaborative models like Collaborative Drug Therapy Management (CDTM) were found to enhance the quality and continuity of care. Additionally, pharmacist engagement contributed to reduced healthcare costs and improved patient reported outcomes, including quality of life and satisfaction. Despite these benefits, systemic barriers such as limited regulatory authority and insufficient clinical training in some regions hinder the broader implementation of pharmacist led care. The review highlights the need for policy reforms, interdisciplinary training, and expanded clinical roles to optimize pharmacist integration. Enhancing the pharmacist’s role in T2DM management offers a promising strategy to advance chronic disease care globally.
References
Li M, Ding L, Hu Y, Qin L, Wu Y, Liu W, et al. Herbal Formula LLKL Ameliorates Hyperglycaemia, Modulates the Gut Microbiota and Regulates the Gut‐liver Axis in Zucker Diabetic Fatty Rats. J Cell Mol Med. 2020;25(1):367–82. DOI: https://doi.org/10.1111/jcmm.16084
Song S, Lee JE. Dietary Patterns Related to Triglyceride and High-Density Lipoprotein Cholesterol and the Incidence of Type 2 Diabetes in Korean Men and Women. Nutrients. 2018;11(1):8. DOI: https://doi.org/10.3390/nu11010008
Soffian SSS, Ahmad SB, Chan H, Soelar SA, Hassan MRA, Ismail N. Management and Glycemic Control of Patients With Type 2 Diabetes Mellitus at Primary Care Level in Kedah, Malaysia: A Statewide Evaluation. Plos One. 2019;14(10):e0223383. DOI: https://doi.org/10.1371/journal.pone.0223383
Rodríguez‐Gutiérrez R, Montori VM. Glycemic Control for Patients With Type 2 Diabetes Mellitus: Our Evolving Faith in the Face of Evidence. Circ Cardiovasc Qual Outcomes. 2016;9(5):504–12. DOI: https://doi.org/10.1161/CIRCOUTCOMES.116.002901
Lin S, Hufanga S, Linhart C, Morrell S, Taylor R, Magliano DJ, et al. Diabetes and Obesity Trends in Tonga Over 40 Years. Asia Pac J Public Health. 2016;28(6):475–85. DOI: https://doi.org/10.1177/1010539516645156
Jensen ET, Stafford JM, Saydah S, D’Agostino RB, Dolan LM, Lawrence JM, et al. Increase in Prevalence of Diabetic Ketoacidosis at Diagnosis Among Youth With Type 1 Diabetes: The SEARCH for Diabetes in Youth Study. Diabetes Care. 2021;44(7):1573–8. DOI: https://doi.org/10.2337/dc20-0389
Hussein Z, Taher SW, Singh HKG, Chee WSS. Diabetes Care in Malaysia: Problems, New Models, and Solutions. Ann Glob Health. 2016;81(6):851. DOI: https://doi.org/10.1016/j.aogh.2015.12.016
Salama MA, Biggs BK, Creo AL, Prissel R, Nofal AA, Kumar S. Adolescents With Type 2 Diabetes: Overcoming Barriers to Effective Weight Management. Diabetes Metab Syndr Obes Targets Ther. 2023;Volume 16:693–711. DOI: https://doi.org/10.2147/DMSO.S365829
Chadha M, Jain S, Chawla R, Dharmalingam M, Chaudhury T, Talwalkar PG, et al. Evolution of Guideline Recommendations on Insulin Therapy in Type 2 Diabetes Mellitus Over the Last Two Decades: A Narrative Review. Curr Diabetes Rev. 2023;19(8). DOI: https://doi.org/10.2174/1573399819666230116150205
Khera R, Scheumie MJ, Lu Y, Ostropolets A, Chen R, Hripcsak G, et al. RESEARCH PROTOCOL: Large-Scale Evidence Generation and Evaluation Across a Network of Databases for Type 2 Diabetes Mellitus. 2021; DOI: https://doi.org/10.1101/2021.09.27.21264139
Metwally AA, Mehta P, Johnson BS, Nagarjuna A, Snyder M. COVID-19–Induced New-Onset Diabetes: Trends and Technologies. Diabetes. 2021;70(12):2733–44. DOI: https://doi.org/10.2337/dbi21-0029
Nurfauzi Y, Wahyono D, Rahmawati F, Yasin NM. Penilaian Kebutuhan Home Pharmacy Care Untuk Pasien Diabetes Mellitus Tipe 2 Yang Disertai Hipertensi Pada Usia Lanjut. J Farm Indones. 2020;17(1):63–77. DOI: https://doi.org/10.31001/jfi.v17i1.768
Syifannisa R, Muthoharoh A, Ningrum WA, Rahmatullah St. Pengaruh Konseling Apoteker Terhadap Kepatuhan Pengobatan Dan Outcome Klinis Pasien DM Tipe 2 Puskesmas Mulyoharjo. J Ilm Kesehat. 2022;15(2):93–102. DOI: https://doi.org/10.48144/jiks.v15i2.1127
Khairunnisa K, Rawitri K, Wiryanto, Wahyuni S. Pengaruh Asuhan Kefarmasian Terhadap Outcome Klinis Dan Kualitas Hidup Pada Pasien Diabetes Melitus Tipe 2. Jfionline Print Issn 1412-1107 E-Issn 2355-696x. 2021;13(2):118–28. DOI: https://doi.org/10.35617/jfionline.v13i2.18
Khotimah K, Rahem A, Adhitama L. Pengetahuan, Sikap, Dan Praktik Apoteker Dalam Penilaian Kepatuhan Pasien Diabetes Di Puskesmas Kota Surabaya. Mpi Media Pharm Indones. 2022;4(1):84–93. DOI: https://doi.org/10.24123/mpi.v4i1.5075
Pratiwi A, Fudholi A, Satibi S. Analisis Faktor Yang Mempengaruhi Implementasi Pelayanan Kefarmasian Puskesmas Di Kota Semarang. Maj Farm. 2021;17(1):1. DOI: https://doi.org/10.22146/farmaseutik.v17i1.46980
Fadilah TN, Kurniawan T, Pebrianti S. Pengetahuan Tentang Pengelolaan Diri Pada Pasien Diabetes Melitus Tipe 2 Beserta Faktor – Faktor Yang Berkontribusi. J Ilm Kesehat Keperawatan. 2023;19(2):151. DOI: https://doi.org/10.26753/jikk.v19i2.1100
Razak A, Ramadhani S, Syafar Muh, Suardi. Studi Pengetahuan, Sikap, Keterampilan Manajemen Diri Dan Dukungan Keluarga Pada Penderita DM Tipe 2 Di Puskesmas Polongbangkeng Selatan. Media Publ Promosi Kesehat Indones Mppki. 2022;5(5):576–81. DOI: https://doi.org/10.56338/mppki.v5i5.2214
Cowart K, Sando KR. Pharmacist Impact on Treatment Intensification and Hemoglobin A1C in Patients With Type 2 Diabetes Mellitus at an Academic Health Center. J Pharm Pract. 2018;32(6):648–54. DOI: https://doi.org/10.1177/0897190018776178
Alghadeer S, Alsuwayni B, Almuwayjid AK, Almadi MS, Mubarak A, Khunayn RM b., et al. Glycemic Control and Management in Pharmacist-Led Diabetic Clinic vs. Physician-Led Diabetic Clinic. Medicina (Mex). 2021;58(1):14. DOI: https://doi.org/10.3390/medicina58010014
Anderegg MD, Gums TH, Uribe L, MacLaughlin EJ, Hoehns JD, Bazaldua OV, et al. Pharmacist Intervention for Blood Pressure Control in Patients With Diabetes and/or Chronic Kidney Disease. Pharmacother J Hum Pharmacol Drug Ther. 2018;38(3):309–18. DOI: https://doi.org/10.1002/phar.2083
Dril EV, Schumacher C. Impact of Professional Continuous Glucose Monitoring by Clinical Pharmacists in an Ambulatory Care Setting. J Am Coll Clin Pharm. 2019;2(6):638–44. DOI: https://doi.org/10.1002/jac5.1088
Bateman MT, McCarthy C, Prioli KM, Wagner M. Post Hoc Depression Analysis From a Pharmacist-Led Diabetes Trial. Ment Health Clin. 2023;13(1):18–24. DOI: https://doi.org/10.9740/mhc.2023.02.018
Clements JN, Schumacher C. Pharmacists in Diabetes Management: Enhancing Patient Care Through Practice, Education, and Advocacy. J Am Coll Clin Pharm. 2025;8(2):74–6. DOI: https://doi.org/10.1002/jac5.2077
Ayadurai S, Sunderland B, Tee LB, Hattingh L. A Training Program Incorporating a Diabetes Tool to Facilitate Delivery of Quality Diabetes Care by Community Pharmacists in Malaysia and Australia. Pharm Pract. 2019;17(2):1457. DOI: https://doi.org/10.18549/PharmPract.2019.2.1457
Nabulsi NA, Yan CH, Tilton J, Gerber BS, Sharp LK. Clinical Pharmacists in Diabetes Management: What Do Minority Patients With Uncontrolled Diabetes Have to Say? J Am Pharm Assoc. 2020;60(5):708–15. DOI: https://doi.org/10.1016/j.japh.2020.01.024
Maiguma T, Komoto A, Shiraga E, Hagiwara S, Onishi J, Li M, et al. Influence of Pharmacist Intervention on Re-Elevation of Glycated Hemoglobin for Diabetic Outpatients. Hosp Pharm. 2019;56(3):191–7. DOI: https://doi.org/10.1177/0018578719883806
Halalau A, Sonmez M, Uddin A, Karabon P, Scherzer ZA, Keeney S. Efficacy of a Pharmacist-Managed Diabetes Clinic in High-Risk Diabetes Patients, a Randomized Controlled Trial - “Pharm-Md.” BMC Endocr Disord. 2022;22(1). DOI: https://doi.org/10.1186/s12902-022-00983-y
Iqbal MZ, Khan AH, Iqbal M, Sulaiman SAS. A Review of Pharmacist-Led Interventions on Diabetes Outcomes: An Observational Analysis to Explore Diabetes Care Opportunities for Pharmacists. J Pharm Bioallied Sci. 2019;11(4):299. DOI: https://doi.org/10.4103/jpbs.JPBS_138_19
Blood A, Saag HS, Chesler A, Ameripour D, Gutiérrez M, Nguyễn VH, et al. Abstract 4137479: Integrating Ambulatory Care Pharmacists Into Value-Based Primary Care: A Scalable Model for Addressing Cardiometabolic Disease. Circulation. 2024;150(Suppl_1):A4137479–A4137479. DOI: https://doi.org/10.1161/circ.150.suppl_1.4137479
Andy A. The Expanding Role of Pharmacists in Patient Centered Diabetes Care Impacts on Management and Outcomes. J Pharm Res Rep. 2023;1–5. DOI: https://doi.org/10.47363/JPRSR/2023(4)E101
Umeh AU, Chima UE, Agbo CE, Chiekwe OS, Eze AR, Nwachuya CA, et al. Pharmacist-Led Medication Therapy Management: Impact on Healthcare Utilization and Costs. Am J Pharmacother Pharm Sci. 2025;4:4. DOI: https://doi.org/10.25259/AJPPS_2025_004
Reff MJ, Shillingburg A, Shah B, Elder CT, Prescott H, Kennerly-Shah J. Front-Line Use of Tyrosine Kinase Inhibitors in Chronic Phase Chronic Myeloid Leukemia: Practice Considerations. J Oncol Pharm Pract. 2019;26(1):156–74. DOI: https://doi.org/10.1177/1078155219864640
Aldaajani MZ, Almutairi AM, Almuteriee EH, Almorshed ASA, Alrbian AAM, Alwalie MS, et al. The Role of Clinical Pharmacists in Chronic Disease Management: Review. Int J Health Sci. 2024;8(S1):1766–76. DOI: https://doi.org/10.53730/ijhs.v8nS1.15389
Dietrich E, Gums JG. Incident-to Billing for Pharmacists. J Manag Care Spec Pharm. 2018;24(12):1273–6. DOI: https://doi.org/10.18553/jmcp.2018.24.12.1273
Shammari YHA, Shammari HAA, Barak TMB, Alharbi BS, Alshammari ST, Alnais SA, et al. Role of Pharmacists in Healthcare Delivery. Int J Health Sci. 2022;5086–98. DOI: https://doi.org/10.53730/ijhs.v6nS9.14840
Afrihyia E. Evaluating the Role of Pharmacists in Chronic Disease Management: A Review of Patient Outcomes and Healthcare Efficiency. Ijamrs. 2025;5(1):1337–43. DOI: https://doi.org/10.62225/2583049X.2025.5.1.4298
Williams D. The Role of the Pharmacist in Optimizing Outcomes With Roflumilast, a PDE4 Inhibitor for the Treatment of COPD. J Pharm Pract. 2020;35(3):445–54. DOI: https://doi.org/10.1177/0897190020969286
Silalahi LE, Prabawati D, Hastono SP. Efektivitas Edukasi Self-Care Terhadap Perilaku Manajemen Diri Pada Pasien Diabetes Melitus Di Wilayah Puskesmas Sukapura Jakarta. Media Publ Promosi Kesehat Indones Mppki. 2021;4(1):15–22. DOI: https://doi.org/10.56338/mppki.v4i1.1385
Rismayanti IDA, Sundayana IM, Ariana PA, Heri M. Edukasi Diabetes Terhadap Penurunan Glukosa Darah Pada Penderita Diabetes Mellitus Tipe 2. J Telenursing Joting. 2021;3(1):110–6. DOI: https://doi.org/10.31539/joting.v3i1.2111
Merlin R, Arozal W, Sauriasari R, Keban SA. Evaluasi Penerapan Booklet Dan Edukasi Apoteker Pada Pasien Diabetes Melitus Tipe 2 Di Rumah Sakit Mayapada Tangerang. Pharm Sci Res. 2017;4(2):102–10. DOI: https://doi.org/10.7454/psr.v4i2.3742
Etlidawati E, Romdhoni MF, Yulistika D, Linggardini K. Self-Management Education Pada Pasien Diabetes Melitus. Faletehan Health J. 2024;11(01):45–50. DOI: https://doi.org/10.33746/fhj.v11i01.679
Megawaty I, Indrawati I, Harli K, Amin M, Wabula I. Efektifitas DSME Pada Penderita Dan Keluarga Terhadap Penurunan Kadar Gula Darah. J-Hest J Health Educ Econ Sci Technol. 2023;5(2):278–86. DOI: https://doi.org/10.36339/jhest.v5i2.108
Putri SSF, Irfannuddin I, Murti K, Kesuma Y, Darmawan H, Koibuchi N. The Role of Gut Microbiota on Cognitive Development in Rodents: A Meta-Analysis. J Physiol Sci. 2023;73(1):10. DOI: https://doi.org/10.1186/s12576-023-00869-1
Lusiana I, Wijoyo Y. Pengaruh Edukasi Apoteker Terhadap Keberhasilan Terapi Pasien Diabetes Mellitus Tipe 2: Literature Review. J Surya Med. 2024;10(3):334–9. DOI: https://doi.org/10.33084/jsm.v10i3.9075
Pranata MM, Dahlia D, Arista L. Efektifitas Intervensi Manajemen Diabetes Berbasis Pemberdayaan Terhadap Kontrol Glikemik: Studi Literatur. J Keperawatan. 2023;15(2):643–52. DOI: https://doi.org/10.32583/keperawatan.v15i2.963
Rahmawati D. Kualitas Hidup Pasien Diabetes Melitus Dan Hipertensi Dalam Program Penyakit Kronis (Prolanis) Di Indonesia: Narative Review. J Mandala Pharmacon Indones. 2024;10(1):116–22. DOI: https://doi.org/10.35311/jmpi.v10i1.531
Putri DR, Komalasari DR, Muazarroh S. Efektivitas Pemberian Neurosensorimotor Reflex Integration (NSMRI) Dan Play Therapy Movement Terhadap Anak Dengan Autism Spectrum Disorder (ASD): A Case Report. Ahmar Metastasis Health J. 2023;3(3):148–53. DOI: https://doi.org/10.53770/amhj.v3i3.205
Setyani ETA, Anggraini D, Aulia RA, Mukti AW. Artikel Review : Peranan Apoteker Dalam Pelayanan Kefarmasian Pada Pasien Diabetes Melitus (DM). Farm J Sains Farm. 2023;4(2):93–106. DOI: https://doi.org/10.36456/farmasis.v4i2.7614
Yuliansyah MH, Triharini M, Yuni I, Prayoga DH. Inovasi Pengembangan Instrumen Perawatan Luka Dalam Meningkatkan Cost Effectiveness. J Manaj Kesehat Yayasan Rs Dr Soetomo. 2024;10(1):91. DOI: https://doi.org/10.29241/jmk.v10i1.1846
Masu VIF, Riwu M, Kareri DGR, Damanik EMB. Diabetes Self Management Education Sebagai Perawatan Mandiri Pasien Diabetes Melitus Di Tengah Masa Pandemi COVID-19 Systematic Review. Cendana Med J Cmj. 2023;11(1):182–92. DOI: https://doi.org/10.35508/cmj.v11i1.10726
Israwati I, Lukman L, Hamid AN. Efektivitas Media Flashcard Untuk Meningkatkan Kemampuan Kognitif Anak Usia Dini. Sultra Educ J. 2022;2(1):1–9. DOI: https://doi.org/10.54297/seduj.v2i1.214
Santi MDS, Ni Wayan Rika Kumara Dewi, Yasa GT. Peningkatan Pemahaman Siswa Farmasi Tentang Peran Farmakoekonomi Dalam Pelayanan Kesehatan Di SMK Bintang Persada Denpasar. J Pengabdi Kpd Masy Wahana Usada. 2022;4(2):82–8. DOI: https://doi.org/10.47859/wuj.v4i2.284
Toyyibah A, Niluh Putu Dian Rosalina Handayani Narsa, Romadhon F. Pengaruh Intervensi Pemerintah Dalam Penanganan Covid-19 Terhadap Return Saham. Wahana Ris Akunt. 2024;12(1):63. DOI: https://doi.org/10.24036/wra.v12i1.124945
Sinuraya RK, Oktrina A, Handayani NK, Destiani DP, Puspitasari IM. Pelayanan Farmasi Klinis Meningkatkan Kontrol Gula Darah Pasien Diabetes Melitus. Indones J Clin Pharm. 2019;8(4):271. DOI: https://doi.org/10.15416/ijcp.2019.8.4.271
Lorensia A, Lamur E. Persepsi Apoteker Terhadap Apoteker Online Di Wilayah Surabaya Timur. Keluwih J Kesehat Dan Kedokt. 2021;2(2):96–101. DOI: https://doi.org/10.24123/kesdok.V2i2.3051
Noormandi A, Karimzadeh I, Mirjalili M, Khalili H. Clinical and Economic Impacts of Clinical Pharmacists’ Interventions in Iran: A Systematic Review. Daru J Pharm Sci. 2019;27(1):361–78. DOI: https://doi.org/10.1007/s40199-019-00245-8
Cheema E, Alhomoud FK, Kinsara ASA, Alsiddik J, Barnawi MH, Al-Muwallad MA, et al. The Impact of Pharmacists-Led Medicines Reconciliation on Healthcare Outcomes in Secondary Care: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Plos One. 2018;13(3):e0193510. DOI: https://doi.org/10.1371/journal.pone.0193510
Laali E, Ghorbani A, Najafi S, Sarayani A, Ghafari S, Makarem J, et al. Evaluation of Pharmacist‐based Interventions to Optimise Utilisation of Parenteral Paracetamol in a Teaching Hospital in Iran. J Pharm Pract Res. 2020;50(1):65–70. DOI: https://doi.org/10.1002/jppr.1558
Almontashiri MH. The Evolving Role of Pharmacists in Healthcare: A Systematic Review of Clinical, Community, and Digital Health Interventions. Ajbr. 2024;1085–91. DOI: https://doi.org/10.53555/AJBR.v27i3.3397
Fazel MT, Bagalagel A, Lee JK, Martin J, Slack M. Impact of Diabetes Care by Pharmacists as Part of Health Care Team in Ambulatory Settings: A Systematic Review and Meta-Analysis. Ann Pharmacother. 2017;51(10):890–907. DOI: https://doi.org/10.1177/1060028017711454
Mekdad S, Alsayed L. Quality Improvement Project to Study the Impact of Clinical Pharmacist in Diabetic Management of Admitted Cardiac Patients. 2022; DOI: https://doi.org/10.21203/rs.3.rs-1947531/v1
Alhabib S, Aldraimly M, Alfarhan A. An Evolving Role of Clinical Pharmacists in Managing Diabetes: Evidence From the Literature. Saudi Pharm J. 2016;24(4):441–6. DOI: https://doi.org/10.1016/j.jsps.2014.07.008
Bharadia R, Lorenz K, Cor K, Simpson SH. Financial Remuneration Is Positively Correlated With the Number of Clinical Activities: An Example From Diabetes Management in Alberta Community Pharmacies. Int J Pharm Pract. 2017;26(1):77–80. DOI: https://doi.org/10.1111/ijpp.12331
Mawardi F, Lestari AS, Kusnanto H, Sasongko EPS, Hilmanto D. Infringement of Clinical Pharmacist’s Authority. Br J Clin Pharmacol. 2024;91(6):1607–9. DOI: https://doi.org/10.1111/bcp.16161
Alqifari SF, AlMharwal BT, Aldawish R, Almokhlef SA. Impact of Pharmacist-Led Clinics on Health Outcomes of Patients With Diabetes at a Ministry of Health Diabetes &Amp; Endocrinology Center, Saudi Arabia: A Retrospective Study. Cureus. 2022; DOI: https://doi.org/10.7759/cureus.25923
Athiyah U, Setiawan CD, Nugaheni G, Zairina E, Utami W, Hermansya A. Assessment of Pharmacists’ Knowledge, Attitude and Practice in Chain Community Pharmacies Towards Their Current Function and Performance in Indonesia. Pharm Pract. 2019;17(3):1518. DOI: https://doi.org/10.18549/PharmPract.2019.3.1518


