Improving Patient Outcomes in Diabetes and Hypertension: The Role of Pharmacists in Public Health Programs

Abstract

Background: Diabetes and hypertension are leading non-communicable diseases contributing to high morbidity and mortality worldwide. Poor disease control, often due to inadequate medication adherence and fragmented care, increases the risk of complications and hospital readmissions. Pharmacist-led interventions, involving medication optimization, patient education, and continuous monitoring, have demonstrated effectiveness in improving chronic disease outcomes. However, their role in inpatient settings remains underexplored, particularly in secondary care hospitals where healthcare resources are often constrained.

Objective: This study evaluates the impact of integrating pharmacists into chronic disease management programs for patients with type 2 diabetes mellitus (T2DM) and hypertension (HTN) in a secondary care hospital.

Methods: A prospective, interventional study was conducted over 12 months at a secondary care hospital, enrolling 210 patients with T2DM and HTN. A pharmacist was integrated into the healthcare team, providing medication therapy management, patient education, and follow-up care. Clinical parameters, including HbA1c, blood pressure, lipid profile, BMI, and medication adherence, were assessed at baseline and follow-up. Statistical analyses included paired t-tests and chi-square tests, with a significance threshold of p < 0.05.

Results: HbA1c levels significantly decreased from 8.5 ± 1.2% to 7.1 ± 1.3% (p < 0.001), while the percentage of patients achieving HbA1c <7% increased from 7.6% to 48.9% (p < 0.001). Systolic blood pressure reduced from 148 ± 18 mmHg to 135 ± 14 mmHg (p < 0.001), and diastolic blood pressure improved from 90 ± 11 mmHg to 85 ± 10 mmHg (p = 0.002). LDL cholesterol levels declined from 130 ± 35 mg/dL to 115 ± 28 mg/dL (p < 0.001), with target LDL levels achieved by 56.2% of patients (p = 0.002). Medication adherence increased by 36% (p < 0.001), and hospital readmissions for diabetes- and hypertension-related complications reduced by 22% (p = 0.004). Screening completion rates for diabetic foot and retinal exams improved by 39% (p < 0.001). Aspirin and ACE/ARB prescriptions increased by 48% and 22%, respectively (p < 0.001).

Conclusion: Pharmacist-led interventions significantly improved glycemic control, blood pressure regulation, medication adherence, and preventive care measures in hospitalized patients with diabetes and hypertension. These findings highlight the essential role of pharmacists in optimizing chronic disease management and reinforce the need for their integration into multidisciplinary healthcare teams.