Abstract
Background: Type 2 diabetes mellitus requires sustained medication adherence, regular monitoring, patient education, and timely intensification of therapy. Clinical pharmacists are increasingly involved in these activities, but the extent of their role depends heavily on health-system organization and scope-of-practice regulations. Canada provides an informative example because pharmacist responsibilities differ between provinces while national diabetes guidance supports interprofessional, patient-centred care.
Objective: To review the impact of pharmacist-led interventions on medication adherence and glycemic control in adults with type 2 diabetes and examine how Canadian health-system models can facilitate their integration into routine care.
Methods: A narrative review was undertaken using Diabetes Canada clinical practice guidance, Canadian regulatory and government sources, Canadian pharmacist-led diabetes studies, and international systematic reviews evaluating medication adherence, glycemic outcomes, and multidisciplinary diabetes care.
Results: Pharmacist interventions including medication review, adherence assessment, patient education, laboratory monitoring, therapeutic optimization, prescribing, and structured follow-up are associated with improved diabetes management. Canadian evidence is particularly notable from Alberta, where pharmacists with additional prescribing authorization may initiate and modify prescription therapy. In the RxING study conducted across 12 Alberta community pharmacies, pharmacist-led initiation and titration of basal insulin reduced mean glycated hemoglobin (A1C) from 9.1% to 7.3% over 26 weeks. Ontario illustrates a different model through the publicly funded MedsCheck for Diabetes program, which emphasizes medication review, education, identification of drug-related problems, and communication with primary-care providers. These provincial examples demonstrate that pharmacist-led diabetes care can be implemented through both expanded prescribing models and collaborative medication-management systems.
Conclusion: Pharmacists can contribute meaningfully to medication adherence, glycemic control, cardiovascular risk reduction, and continuity of diabetes care. Canadian experience suggests that the greatest benefit is achieved when pharmacist interventions are supported by structured follow-up, access to clinical information, appropriate scope of practice, remuneration, and integration with primary-care teams.
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Ethics & Declarations
Author Contributions
All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. All authors read and approved the final manuscript.
Ethics Approval and Consent to Participate
Ethical approval was not required for this study. There were no participants so consent was not needed.
Consent for Publication
Consent for publication was not required for this study.
Competing Interests
The author declares that he has no competing financial or non financial interests
Funding
This research received no external funding.
Data Availability Statement
Data sharing is not applicable to this article.
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© 2026 Mohamed Abdellatif et al. International Journal of Clinical Pharmacy and Medicine.