Pharmacist Intervention for Safer Prescribing in Patients With Type 2 Diabetes at High Risk: A Randomized Clinical Trial
Primary result · Prescribed a safer diabetes regimenResult — go to the resultRisk difference 12.3% 95% CI 0.6%–24.0%Authors' conclusion
In this randomized clinical trial, adding proactive, protocol-driven clinical pharmacist outreach into collaborative team-based care improved medication optimization and patient outcomes. This approach provides an evidence-based strategy for reducing the risk of developing severe hypoglycemia in individuals with T2D at high risk, enhancing patient safety, and potentially reducing overall health care cost.
Study context
- Population
- Adults with T2D at high risk of hypoglycemia per a validated risk tool, Kaiser Permanente Northern California; mean (SD) age 71.3 (11.5) years, 52.4% female191 in ITT cohort
- Participants
- 200 adults
- Comparison
- Proactive clinical pharmacist outreach vs usual care
- Primary endpoint
- Proportion prescribed safer (less hypoglycemia-prone) diabetes regimens: discontinuation of SU and/or rapid-, short-acting or mixed insulins
- Follow-up
- 6 months
Methodological details1:1 randomisation, protocol-driven pharmacist outreach, integrated health care delivery system, Conducted July 20, 2023 to January 22, 2024; follow-up through January 2025
- 1:1 randomisation
- Protocol-driven pharmacist outreach
- Integrated health care delivery system
- Conducted July 20, 2023 to January 22, 2024; follow-up through January 2025
Primary result
Prescribed a safer diabetes regimen
Risk difference
12.3%
95% CI 0.6%–24.0%
Events by treatment group
Interventionvs Control
risk difference 12.3% (95% CI 0.6%–24.0%)
As reported in the abstract
Further findings
| Outcome | Intervention | Control | RD (95% CI) | |
|---|---|---|---|---|
| HbA1c <8% | 61.8% | 63.6% | −1.8% (−17.0% to 13.5%) | |
| −20−1001020Difference (linear scale) |
Hemoglobin A1c (HbA1c) <8%
- No worsening of HbA1c control with intervention vs control
Safety
| Outcome | Intervention | Control | RD (95% CI) | |
|---|---|---|---|---|
| Hypoglycemia-related ED or inpatient encounters | 0 events | 5.3% | −5.3% (−11.8% to −1.3%) | |
| −15−10−505Difference (linear scale) |
Original publication
Pharmacist Intervention for Safer Prescribing in Patients With Type 2 Diabetes at High Risk: A Randomized Clinical Trial. JAMA Netw Open. Published 2 February 2026. doi:10.
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