Introduction: Medication nonadherence is the most common issue observed in the management of diabetes because of complex and lifelong therapy. The study aimed to assess the effect of pharmacist-directed counseling and daily text message reminder on medication adherence and clinical profile of patients with type II diabetes. Materials and Methods: This prospective, open-labeled, randomized control trial was carried out in outpatient medical department of a secondary care referral hospital. A total of 330 patients who met study criteria were enrolled and randomized into an intervention group ( n = 165), received counseling and daily messages about medication intake and control group ( n = 165), and usual care by physician. Medication adherence and clinical outcomes such as glycosylated hemoglobin (HbA1C), systolic blood pressure (SBP), low-density lipoprotein (LDL) cholesterol, triglyceride (TG) levels, and body mass index (BMI) were recorded at baseline and follow-up visits. Two-sample Wilcoxon rank sum test was used to compare the mean difference of medication adherence and paired t -test was used to compare clinical outcomes. Results and Discussion: The mean age of intervention and control groups were 57.1 ± 8.55 and 58.5 ± 8.53 years, respectively. The mean difference of medication adherence from baseline to second follow-up visit was significantly more in intervention group (12.2 ± 7.1%) compared to that in control group (0.75 ± 10.2 %) with a P < 0.001. From baseline to second follow-up visit, HbA1C (7.79 ± 0.67 to 6.91 ± 0.83 %), SBP (136.75 ± 20.09 to 126.23 ± 18.22 mm Hg), and LDL cholesterol (104.14 ± 26.23 to 98.29 ± 20.87 mg/dL) levels were significantly reduced in intervention group compared to that in control group with a P < 0.01. No significant improvement was observed in TG (169± 33.71 to 168 65 ± 33.90 mg/dL) and BMI (27.9 ± 4.21 to 27.1 ± 3.12 Kg/m 2 ) levels from baseline to second follow-up visit. Conclusion: Pharmacist-directed patient counseling combined with message reminder showed a greater effect on the improvement of medication adherence and control of glycemia, blood pressure, and lipid profile in diabetes.

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The pharmacist plays an important role in providing counseling services to patients suffering with various chronic disorders and to improve health outcomes. The study aims to evaluate the effect of pharmacist mediated counseling on Knowledge, Attitude, and Practice (KAP) and medication adherence (MA) among hypothyroidism patients attending outpatient department of a secondary care referral hospital. This is a Quasi-Experimental design without control. A total of 403 patients were enrolled and subjected for KAP assessment by pre-validated questionnaire, and medication adherence levels by pill count and visual analogue scale methods. All patients were counselled by the pharmacist regarding hypothyroidism and its management. After three months, post-KAP and medication adherence levels were measured. Chi-square test was used to compare the adequacy of KAP levels. The paired t-test was used to compare mean medication adherence and mean KAP percentage levels. The mean KAP percentage levels were significantly improved after counselling (80.5±16.4; 86.2±15.7; 67.5±13.8) compared to before (34.1±21.7; 33.8±22.9; 24.5±20.9) with a P value less than <0.0001. There was a significant improvement in mean medication adherence levels measured by visual analogue scale method and pill count method after counselling (92.4±4.8, 97.4±3.2) compared to before counselling (76.8±6.8, 80.3±6.4). The study illustrates how pharmacist plays an integral part in improving medication adherence and KAP towards hypothyroidism management. Improving KAP and medication adherence levels will promote positive clinical outcomes and prevents complications associated with hypothyroidism.