Digital pharmacist-physician care improves HbA1c in type 2 diabetes
Key takeaway:
A 12-month cluster trial in 574 adults with type 2 diabetes found that digital pharmacist-physician care improved HbA1c, cardiovascular risk, waist measures, and satisfaction compared with usual physician care.
Study at a glance
What was studied
Digital physician-pharmacist collaborative care for type 2 diabetes management
Study type
Randomized Controlled Trials (RCTs)
duration
Medium-Term (3–12 mo)
Intervention
Digital physician-pharmacist collaborative care
Outcomes
HbA1c, 10-year ASCVD risk, Fasting glucose, Postprandial glucose, Waist circumference, Waist-to-hip ratio, Systolic blood pressure, Diastolic blood pressure, Triglycerides, Total cholesterol, Treatment satisfaction, Total diabetes-related cost
Funding
Non-industry sponsored
Main effects
↓ HbA1c improved more with digital physician-pharmacist care than usual care (−2.57% vs −1.96%)
↓ 10-year ASCVD risk decreased compared with usual care (adjusted β −1.206)
↑ Treatment satisfaction was higher in the intervention group after 12 months
Evidence Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
 Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) |  10-year ASCVD risk (Metabolic Health) | Decrease | Strong |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | Diastolic blood pressure (Metabolic Health) | Decrease | Mixed |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) |  Fasting glucose (Glycemic Control) | Decrease | Limited |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | HbA1c (Glycemic Control) | Decrease | Strong |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | Postprandial glucose (Glycemic Control) | Decrease | Mixed |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | Systolic blood pressure (Metabolic Health) | Decrease | Mixed |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | Total cholesterol (Metabolic Health) | Decrease | Mixed |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) |  Total diabetes-related cost (Patient-Reported) | Decrease | Mixed |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | Treatment satisfaction (Patient-Reported) | Increase | Strong |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | Triglycerides (Metabolic Health) | Decrease | Mixed |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) |  Waist circumference (Weight & Anthropometrics) | Decrease | Strong |
Digital physician-pharmacist collaborative care (Behavioral & Lifestyle) | Waist-to-hip ratio (Weight & Anthropometrics) | Decrease | Mixed |
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Evidence Suggest
- A structured pharmacist-physician model can improve HbA1c in primary care adults with type 2 diabetes
- Remote education and in-person pharmacist visits may support broader cardiometabolic improvements
- The model may reduce total diabetes-related costs, mainly through lower hospitalization costs
Who this applies to
Adults with type 2 diabetes and HbA1c above 7.5%
Keep in Mind
This was a cluster trial, so results depend partly on clinic-level implementation
Between the Lines
- Participants and clinicians could not be blinded to the intervention
- Only six primary care centers were randomized, which limits cluster-level precision
- COVID-19 may have affected care-seeking behavior during the trial
- Some secondary outcomes may have been underpowered
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Journal Reference
Xiao J, Wang Q, Tan S, et al. Effect of a Digital-Driven Physician-Pharmacist Collaborative Model for Diabetes in Primary Health Care: Cluster Randomized Trial. J Med Internet Res. 2026;28:e77470. doi:10.2196/77470
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