Impact of Diabetes Care by Pharmacists as Part of Health Care Team in Ambulatory Settings: A Systematic Review and Meta-analysis

Maryam T. Fazel, Alaa Bagalagel, Jeannie K. Lee, Jennifer R. Martin, Marion K. Slack

Research output: Contribution to journalReview articlepeer-review

67 Scopus citations


Objective: To conduct a comprehensive systematic review and meta-analyses examining the impact of pharmacist interventions as part of health care teams on diabetes therapeutic outcomes in ambulatory care settings. Data Sources: PubMed/MEDLINE, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, Web of Science, Scopus, WHO’s Global Health Library,, and Google Scholar were searched (1995 to February 2017). Search terms included pharmacist, team, and diabetes. Study Selection: Full-text articles published in English with comparative designs, including randomized controlled trials, nonrandomized controlled trials, and pretest-posttest studies evaluating hemoglobin A1C (A1C), were assessed. Data Extraction and Synthesis: Two reviewers independently screened for study inclusion and extracted data. Quality of the studies was assessed using tools developed based on the framework of the Cochrane Collaboration’s recommendations. Data Synthesis: A total of 1908 studies were identified from the literature and reference searches; 42 studies were included in the systematic review (n = 10 860) and 35 in the meta-analyses (n = 7417). Mean age ranged from 42 to 73 years, and 8% to 100% were male. The overall standardized mean difference (SMD) for A1C for pharmacist care versus comparison was 0.57 (P < 0.01), a moderate effect representing a mean difference of 1.1% (95% CI = 0.88-1.27). The effects for systolic blood pressure and low-density lipoprotein cholesterol were between small and moderate (SMD = 0.31 and 0.32; P < 0.01). The heterogeneity was high for all outcomes (>83%), indicating functional differences among the studies. No publication bias was detected. Conclusion: Pharmacists’ interventions as part of the patient’s health care team improved diabetes therapeutic outcomes, substantiating the important role of pharmacists in team-based diabetes management.

Original languageEnglish (US)
Pages (from-to)890-907
Number of pages18
JournalAnnals of Pharmacotherapy
Issue number10
StatePublished - Oct 1 2017


  • ambulatory care
  • clinical practice
  • diabetes
  • meta-analysis
  • pharmaceutical care

ASJC Scopus subject areas

  • Pharmacology (medical)


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