Telephone-based pharmacist counseling shows limited benefit for blood sugar control in diabetes

Moderate confidence

some concerns bias

Last updated May 28, 2026

Key takeaway:

A telephone-based pharmacist-delivered counseling program using motivational interviewing and shared decision-making did not improve HbA1c or medication adherence in patients with poorly-controlled type 2 diabetes.

Study at a glance

What was studied

Telephone pharmacist counseling using motivational interviewing and shared decision-making for diabetes

Study type

Randomized Controlled Trials (RCTs)

duration

Medium-Term (3–12 mo)

Intervention

Behavioral counseling

Outcomes

HbA1c, Treatment adherence

Funding

Industry sponsored

Main effects

HbA1c change was not significantly different between groups (↔ no effect)

Medication adherence did not improve with the intervention (↔ no effect)

Patients who actually received the intervention showed improved HbA1c (↓ positive in as-treated analysis)

Evidence Summary

Intervention	Outcome	Measured Change	Study Effect
Behavioral counseling (Behavioral & Lifestyle)	HbA1c (Glycemic Control)	Uncertain	Limited
Behavioral counseling (Behavioral & Lifestyle)	Treatment adherence (Adherence & Engagement)	Uncertain	Limited

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Evidence Suggest

Telephone-based pharmacist counseling with motivational interviewing did not improve glycemic control in intention-to-treat analysis
Only about 30% of patients engaged with the intervention, limiting its population-level impact
Most patients identified diet and exercise as primary barriers, not medication adherence

Who this applies to

Adults aged 18-64 with poorly-controlled type 2 diabetes (HbA1c ≥8%)

Keep in Mind

The intervention did not improve outcomes in the main analysis, so results should be interpreted cautiously

Between the Lines

Only 30% of patients accepted the intervention, reducing statistical power
Open-label design may have introduced bias in self-reported measures
HbA1c data missing for 28.6% of patients at follow-up

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Journal Reference

Lauffenburger JC, Ghazinouri R, Jan S, Makanji S, Ferro CA, Lewey J, et al. Impact of a novel pharmacist-delivered behavioral intervention for patients with poorly-controlled diabetes: The ENhancing outcomes through Goal Assessment and Generating Engagement in Diabetes Mellitus (ENGAGE-DM) pragmatic randomized trial. PLoS One. 2019;14(4):e0214754.