{"doi":"10.54133/ajms.v9i1.2339","title":"Impact of Clinical Pharmacist Intervention and Dapagliflozin Add-On Therapy on Glycemic Control in Type 2 Diabetes","abstract":"<jats:p>Background: Type 2 diabetes is a major global health issue. Poor glycemic control, often due to non-adherence, increases complications. Pharmacologic intensification and pharmacist-led interventions help optimize diabetes management. Objectives: To assess clinical pharmacist interventions and dapagliflozin effects on glycemic control, safety, and adherence in type 2 diabetes. Methods: A 3-month, three-arm open-label randomized controlled trial (RCT) conducted in Sulaimani city, Iraq, on adults with T2DM (HbA1c 7–10%, n=138) were randomized to dapagliflozin add-on (G1, n=46), clinical pharmacist intervention (G2, n=46; including medication optimization, adherence support, and counselling), or standard therapy (G3, n=46). Primary outcomes were HbA1c, fasting plasma glucose (FPG) changes, and safety; secondary included lipids, blood pressure, and adherence (Modified Hill-Bone scale). Results: Among 125 completers, the median (IQR) difference in the HbA1c % was -0.7(-1.6 to 0.0) for G1, -0.665 (-1.55 to -0.245) for G2, and +0.05 (-0.3 to 0.597) for G3, which was significantly different between G1 and G3 and G2 and G3. The difference in the FPG was -37 (-83 to 1.0) for G1, -14.5 (-38.75 to 6) for G2, and -1.5 (-11.75 to 30.75) for G3. The difference is significant between G1 and G3, and G2 and G3. Medication adherence improved significantly only in G2 (high adherence: 80% to 95%, p=0.043). Adverse events were low in all groups (hypoglycemia: 4.5–7.3%), while UTIs were 7.3% in G1 only. Conclusions: Clinical pharmacist-led interventions were equally as effective as dapagliflozin for glycemic control but superior in enhancing medication adherence.</jats:p>","journal":"Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 )","year":2025,"id":669796,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1749366,"name":"Rawa Abdullatif Ratha","orcid":null,"position":1,"is_corresponding":false},{"id":1749367,"name":"Taha Othman Mahwi","orcid":"0000-0001-9477-8814","position":2,"is_corresponding":false},{"id":1749365,"name":"Mohammed Abdalaziz Hama amin","orcid":"0009-0003-3443-2063","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Impact of Clinical Pharmacist Intervention and Dapagliflozin Add-On Therapy on Glycemic Control in Type 2 Diabetes","abstract":"<jats:p>Background: Type 2 diabetes is a major global health issue. Poor glycemic control, often due to non-adherence, increases complications. Pharmacologic intensification and pharmacist-led interventions help optimize diabetes management. Objectives: To assess clinical pharmacist interventions and dapagliflozin effects on glycemic control, safety, and adherence in type 2 diabetes. Methods: A 3-month, three-arm open-label randomized controlled trial (RCT) conducted in Sulaimani city, Iraq, on adults with T2DM (HbA1c 7–10%, n=138) were randomized to dapagliflozin add-on (G1, n=46), clinical pharmacist intervention (G2, n=46; including medication optimization, adherence support, and counselling), or standard therapy (G3, n=46). Primary outcomes were HbA1c, fasting plasma glucose (FPG) changes, and safety; secondary included lipids, blood pressure, and adherence (Modified Hill-Bone scale). Results: Among 125 completers, the median (IQR) difference in the HbA1c % was -0.7(-1.6 to 0.0) for G1, -0.665 (-1.55 to -0.245) for G2, and +0.05 (-0.3 to 0.597) for G3, which was significantly different between G1 and G3 and G2 and G3. The difference in the FPG was -37 (-83 to 1.0) for G1, -14.5 (-38.75 to 6) for G2, and -1.5 (-11.75 to 30.75) for G3. The difference is significant between G1 and G3, and G2 and G3. Medication adherence improved significantly only in G2 (high adherence: 80% to 95%, p=0.043). Adverse events were low in all groups (hypoglycemia: 4.5–7.3%), while UTIs were 7.3% in G1 only. Conclusions: Clinical pharmacist-led interventions were equally as effective as dapagliflozin for glycemic control but superior in enhancing medication adherence.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"19162232","pmcid":null,"openalex_id":"https://openalex.org/W4413521730","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.24556123,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by-nc-sa","oa_locations":[{"url":"https://ajms.iq/index.php/ALRAFIDAIN/article/download/2339/560","host_type":"journal"},{"url":"https://ajms.iq/index.php/ALRAFIDAIN/article/download/2339/560","host_type":"GOLD"},{"url":"https://ajms.iq/index.php/ALRAFIDAIN/article/download/2339/560","host_type":"publisher"},{"url":"https://doi.org/10.54133/ajms.v9i1.2339","host_type":"journal"}],"fields_of_study":["Diabetes Treatment and Management","Diabetes Management and Research","Pharmacology and Obesity Treatment","Medicine"],"mesh_terms":[],"keywords":["Dapagliflozin","Glycemic","Medicine","Type 2 diabetes","Pharmacist","Diabetes mellitus","Intervention (counseling)","Physical therapy","Family medicine","Pharmacy","Nursing","Endocrinology"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-15T04:35:43.457147Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}