Abstract
Introduction
Diabetes mellitus (DM) requires effective and accessible management strategies to reduce complications and improve patient outcomes. The aim of this study is to evaluate the effects of a standardised diabetes service delivered by trained community pharmacists on glycaemic control, cardiovascular risk parameters and self-care behaviours among patients with DM.
Methods
This retrospective cohort study included adults with type 1 or type 2 DM (HbA1c ≥7%) who visited community pharmacies in Southeastern Serbia. Patients were offered a structured, four-month service with individualised counselling, monitoring and support from trained pharmacists. Based on willingness to participate, patients were assigned to the intervention (received all four sessions) or control group (received usual pharmacy care). Data on HbA1c, fasting blood glucose, lipid profile, blood pressure and self-care (assessed by Diabetes Self-Management Questionnaire) were collected at baseline and after four months.
Results
Among 390 consenting patients, 213 met the eligibility criteria (intervention: n=105; control: n=108). In the intervention group, HbA1c significantly decreased from 8.61±1.26% to 7.68±0.92% (p<0.001), with 20% of patients achieving target levels (<7%). LDL cholesterol also decreased significantly (from 2.31±0.70 to 1.46±0.66 mmol/L, p<0.001), while no significant changes were observed in HDL, triglycerides, or blood pressure. Self-care behaviour improved across all five subscales, especially medication-taking, where non-adherence decreased from 43.8% to 22.9%. Greater improvements were noted among patients with type 2 DM and those with a family history of diabetes.
Conclusions
The pharmacist-led service significantly improved glycaemic control, LDL cholesterol, and self-care behaviour. These findings highlight pharmacists’ potential to enhance diabetes management and support public health efforts.