A retrospective multicentre study on the outcomes of the pharmacist-managed Diabetes Medication Therapy Adherence Clinic programme in primary health clinics across Johor, Malaysia.

Introduction: The Diabetes Medication Therapy Adherence Clinic (DMTAC) programme is an ambulatory care service provided by trained pharmacists in collaboration with doctors. It supports improved glycaemic control by enhancing patients' understanding and treatment adherence through education.

Methods: Patients enrolled in the DMTAC programme in all 84 health clinics in Johor from January 2016 to December 2017 were included. Demographic characteristics, diabetic and medication history, current treatments, comorbidities and therapeutic outcomes (glycosylated haemoglobin A1c [HbAlc] level and lipid profile) were collected and reviewed retrospectively. Baseline HbAlc levels and lipid profiles were taken from patients' medical records during their first visits and post-intervention values from follow-up data, including the most recent information documented during the last DMTAC pharmacist visit before December 2017.

Results: A total of 1107 patients (693 women and 414 men) with type 2 diabetes mellitus aged 24-88 years were included. The mean HbA1c level significantly decreased by 0.92±1.94%. The mean total cholesterol (-0.27 mmol/L), low-density lipoprotein (-0.31 mmol/L) and triglyceride levels (-0.14 mmol/L) slightly but significantly decreased. Both systolic and diastolic blood pressures also showed small but significant reductions from 142/81 mmHg pre-intervention to 137/79 mmHg postintervention. The patients' understanding scores improved from 87.94% to 98.55% after their fourth DMTAC pharmacist visit.

Conclusion: The DMTAC programme in public health clinics across Johor, Malaysia, significantly improves HbA1c levels, fasting blood glucose levels, lipid profiles, BPs and medication understanding, with DMTAC pharmacists playing a key role in supporting multidisciplinary teams through targeted interventions and counselling.