Pharmacist-Led Counselling and Culturally Adapted Health Journaling in Type 2 Diabetes: A Randomized Controlled Trial

Background

Type 2 Diabetes Mellitus (T2DM) requires lifelong self-management involving medication adherence, diet, physical activity, blood glucose monitoring, and foot care. Sustained adherence remains challenging, creating a need for effective patient-support strategies.

Objectives

To evaluate the effect of pharmacist-led counselling with an educative health journal on diabetes-related knowledge, attitudes, and self-care practices in patients with T2DM.

Materials and Methods

A prospective, parallel-group, open-label randomised controlled trial was conducted among 101 patients with T2DM attending the outpatient department of a tertiary care hospital in Gujarat, India. Participants were randomised to intervention (n=50) or control (n=51). The intervention group received structured pharmacist-led counselling with an educational health journal, while controls received routine care. Knowledge, Attitudes, and Practices (KAP) were assessed at baseline and one month using a 28-item questionnaire. Baseline-adjusted analyses were performed, with p<0.05 considered significant.

Results

Baseline characteristics were comparable. After one month, the intervention group showed significantly greater improvement across all KAP domains. Median total KAP improvement was 42.31% (IQR: 34.62-50.00) versus 3.85% in controls. ANCOVA confirmed significantly higher follow-up scores across all domains (all p<0.001), with large effect sizes for knowledge (partial η²=0.714) and practice (partial η²=0.696).

Conclusion

Pharmacist-led counselling along with an educative health journal significantly improved diabetes-related knowledge, attitudes, and self-care practices. This low-cost intervention is feasible in routine outpatient care and may strengthen long-term diabetes self-management.