Pharmacist-led medication therapy management improving medication adherence in a patient with type 2 diabetes: case...

Poor 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.

A 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.

After 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.

Improvements in medication adherence and clinical outcomes were achieved following comprehensive pharmacist-led medication therapy management integrated with individualized clinical management in this case.