Medication management in patients with diabetes: Exploring the role of the pharmacist

Successful medication use depends on several factors, including medication management. Medication management is the monitoring, evaluation and optimization of medication use by a particular patient and is a multidisciplinary effort between patient, pharmacist and physician. The aim of this thesis is to explore how the role of the pharmacist in medication management in patients with diabetes can be enhanced. We used both quantitative and qualitative methods and we combined patient’s perspectives and healthcare provider’s perspectives to gain insight into this subject.
A considerable proportion of patients with diabetes treated in primary care have uncontrolled HbA1c values. This is partly due to problems with medication management. Among primary healthcare providers, pharmacists are the medication experts and previous studies have shown their added value in medication management support. This role is also acknowledged by other primary care providers and patients. Patients particularly value the supportive role of pharmacists and indicate the accessibility of pharmacists when it comes to sharing problems, either directly or indirectly related to medication use. However, a trusted relationship between patient and pharmacist is key in the process of sharing problems. Pharmacists have an open attitude towards patients when it comes to communication, though conversations are often non-explicit. This could lead to less efficient consultations and missing the actual cause of the problem. On the other hand, pharmacists are able to offer appropriate support in case of known medication management problems. To conclude, adequate medication management is a complex matter and requires continuous collaboration between all parties involved.