Researchers studied a special program where pharmacists coach patients with poorly controlled diabetes through video calls. The program helps patients manage their medications, eat better, exercise more, and deal with stress. In this study, 239 patients who got the coaching were compared to 815 patients who didn’t. The results showed that patients in the coaching program had slightly better blood sugar control and spent fewer days in the hospital. The program also saved money overall, making it a practical option for helping people with diabetes manage their condition better.
The Quick Take
- What they studied: Whether a diabetes coaching program run by pharmacists through video calls helps patients control their blood sugar better and reduces hospital visits and costs
- Who participated: 1,054 patients with diabetes that wasn’t well-controlled (blood sugar levels stayed too high). 239 patients joined the coaching program, and 815 didn’t. All patients were treated at a diabetes clinic in Worcester, Massachusetts between 2020 and 2023
- Key finding: Patients who got pharmacist coaching had blood sugar levels that dropped about 0.4 percentage points more than the comparison group. They also spent about 5 fewer days in the hospital per year and saved the healthcare system around $2,649 per patient annually
- What it means for you: If you have diabetes that’s hard to control, working with a pharmacist coach through video calls may help you manage it better and reduce hospital visits. However, the improvements were modest, and this program works best as part of your overall diabetes care team, not as a replacement for your regular doctor
The Research Details
This was a retrospective cohort study, which means researchers looked back at patient records from 2020 to 2023 to see what happened. They compared two groups: people who enrolled in the Diabetes Care Coach program and people who didn’t. To make the comparison fair, they matched patients in both groups based on similar characteristics like age, other health conditions, and how high their blood sugar was at the start.
The coaching program included regular video calls with a pharmacist who helped patients with several things: taking their diabetes medications correctly, making better food choices, exercising more, using diabetes technology like glucose monitors, getting mental health support if needed, and addressing life challenges that make diabetes harder to manage (like not having enough money for food).
Researchers tracked three main things: how much patients’ blood sugar improved (measured by A1c levels), how many times they went to the emergency room or stayed in the hospital, and how much money the healthcare system spent on their care.
This study design is important because it looks at real-world results from actual patients in a real healthcare system, not just what happens in a controlled research setting. By matching patients with similar starting conditions, researchers could fairly compare the two groups. Tracking both health improvements and costs shows whether the program actually helps patients and makes financial sense for healthcare systems
This study has several strengths: it included over 1,000 patients, used real medical records and insurance data, and looked at multiple outcomes (blood sugar, hospital use, and costs). However, because it’s a retrospective study looking backward at records, researchers couldn’t control everything the way they could in an experiment where people are randomly assigned to groups. The improvements in blood sugar were small, and some of the cost savings had wide ranges of uncertainty, meaning the actual savings could be smaller or larger than reported
What the Results Show
Patients in the coaching program had their blood sugar (A1c) drop by an average of 0.4 percentage points more than the comparison group. While this might sound small, for people with very high blood sugar (9% or higher), even small improvements matter for preventing complications like heart disease, kidney problems, and vision loss.
Among patients whose insurance data was available for cost tracking, those in the coaching program spent about 5 fewer days in the hospital per year compared to the comparison group. This is a meaningful reduction because hospital stays are expensive and can be stressful for patients.
The program saved approximately $2,649 per patient per year in total medical costs. This includes savings from fewer hospital visits and emergency room trips. Importantly, the program paid for itself through these savings, plus additional revenue from a special pharmacy program that helps reduce medication costs for vulnerable patients.
The study found that the program was particularly valuable for patients with Medicaid insurance, who often face more barriers to managing their diabetes. About one-third of participants had Medicaid, and the program helped make healthcare more affordable and accessible for this group. The fact that the program was cost-neutral (didn’t cost extra money) is important because it means healthcare systems can offer it without worrying about increased expenses
Previous research has shown that coaching and support programs can help people with diabetes, but most studies looked at programs in research settings rather than real healthcare clinics. This study adds to that evidence by showing that pharmacist-led coaching works in actual medical practices. The results align with other research suggesting that frequent contact and personalized support improve diabetes control, though the improvements here were modest compared to some other intensive programs
The study looked backward at existing records rather than randomly assigning people to coaching or no coaching, which means some differences between groups might have affected the results in ways researchers couldn’t fully account for. The blood sugar improvements were small and had a wide range of uncertainty. The study was done at one healthcare system in Massachusetts, so results might be different in other parts of the country or in different types of healthcare settings. We don’t know how long the benefits lasted after the study ended, or whether patients who stayed in the program longer had better results
The Bottom Line
If you have diabetes that’s difficult to control, ask your doctor about pharmacist coaching programs, especially if they’re available through your healthcare system. The evidence suggests these programs may help improve blood sugar control and reduce hospital visits. This should be used alongside, not instead of, regular doctor visits and diabetes medications. The program appears most helpful for people with very high blood sugar levels (A1c of 9% or higher) and may be especially valuable if you have limited access to healthcare or financial challenges
This research is most relevant for people with type 2 diabetes whose blood sugar remains high despite taking medications. It’s also important for healthcare systems and insurance companies looking for affordable ways to help patients manage chronic diseases. People with type 1 diabetes, those with well-controlled diabetes, or those without access to telehealth may have different results. If you’re pregnant, have severe kidney disease, or have other serious health conditions, talk to your doctor about whether this type of program is right for you
Based on this study, you might expect to see improvements in blood sugar control within a few months of starting the coaching program, with the most noticeable benefits appearing after 6-12 months of regular participation. Reductions in hospital visits may take longer to appear. The key is consistent participation in the coaching sessions and following the recommendations provided
Want to Apply This Research?
- Track your A1c levels every 3 months (or as recommended by your doctor) and log your blood sugar readings daily if you use a glucose monitor. Also track the number of times you visit the emergency room or get hospitalized each month to see if the program is reducing these visits
- Use the app to schedule and attend your pharmacist coaching video calls, log your medications to make sure you’re taking them correctly, record what you eat to improve nutrition choices, and track physical activity minutes. Set reminders for medication times and coaching appointments to build consistent habits
- Create a dashboard showing your A1c trend over time, monthly hospital visit counts, and adherence to coaching sessions. Review this monthly with your pharmacist coach to identify what’s working and what needs adjustment. Track which coaching topics (medication management, nutrition, exercise, stress) have the biggest impact on your blood sugar control
This research describes one healthcare program’s results and should not be considered medical advice. Individual results vary based on personal health conditions, medications, and commitment to the program. Before starting any diabetes coaching program or making changes to your diabetes care, consult with your doctor or endocrinologist. This study was conducted at one healthcare system and may not apply to all settings or populations. Always work with your healthcare team to develop a diabetes management plan tailored to your specific needs.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.