Narrative Review: The Effect of Counseling on Adherence in Patients with Type 2 Diabetes Mellitus

Gandis Larasati; Diana Ramatillah; Kashif Khan

doi:10.47134/scpr.v2i4.5357

Authors

Gandis Triwidya Larasati Universitas 17 Agustus 1945
Diana Laila Ramatillah Universitas 17 Agustus 1945
Kashif Ullah Khan Universiti Malaya

DOI:

https://doi.org/10.47134/scpr.v2i4.5357

Keywords:

Type 2 Diabetes Mellitus, Adherence, Pharmaceutical Counseling

Abstract

This study aimed to evaluate the effect of counseling on medication adherence among patients with type 2 diabetes mellitus through a narrative review of 50 national and international articles published between 2020 and 2025. The narrative review method was conducted by selecting journals from Elsevier, MDPI, PubMed, SpringerLink, Wiley, as well as nationally indexed SINTA journals using relevant keywords.The results of the review indicate that pharmacist-led interventions through counseling, including brief counseling, home pharmacy care, and digital media–based education, consistently improved patient knowledge, enhanced medication adherence, and reduced clinical parameters such as blood glucose levels, HbA1c, and HOMA-IR. These interventions also improved patients’ quality of life and disease perception.Based on these findings, it can be concluded that pharmacist-led interventions through structured counseling and pharmaceutical education have a significant positive impact on the management of type 2 diabetes mellitus, particularly in improving patient knowledge, disease perception, and adherence to therapy. Improvements in therapeutic behavior directly contributed to better clinical outcomes, including reductions in blood glucose, HbA1c, HOMA-IR, body weight, and waist circumference after 90 days of intervention. The greatest effects were observed in patients with HbA1c levels > 9%, indicating that high-risk groups derived the greatest benefit from pharmacist involvement in the management of type 2 diabetes mellitus.Future studies are recommended to evaluate the long-term effects of counseling and to standardize adherence assessment instruments. Strengthening pharmaceutical care policies is also recommended to improve the quality and consistency of counseling services and to develop sustainable intervention models in primary healthcare settings.

References

Abidin, A., & Rahmat, R. A. (2025). Efektivitas Konseling Apoteker dalam Menurunkan Tingkat Ketidakpatuhan Terapi Diabetes Mellitus. Barongko Jurnal Ilmu Kesehatan, 4(1), 148–161.

Agusnur, A. (2025). Evaluasi efektivitas program konseling farmasi dalam meningkatkan kepatuhan pasien. Jurnal Kesehatan Dan Farmasi, 1(1), 16–22.

Agustini, S., Jumiyati, & Kusdalinah. (2024). Konseling Gizi Dapat Menurunkan Kadar Gula Darah dan Asupan Karbohidrat pada Penderita Diabetes Melitus. Jurnal Vokasi Keperawatan, 7(1), 63–72.

Ahmed, I., Javed, A., Ullah, N., & Kaifi, H. M. (2025). Impact of Online Diabetes Education Counseling on Treatment adherence and Quality of Life of Type-II Diabetics. Pak J Med Sci, 41(3), 843–847.

Amila, & Sembiring, E. (2021). Medication Adherence Improvement of Patients with Type 2 Diabetes Mellitus. International Journal of Nursing and Health Services ( IJNHS ), 4(3), 258–265.

Asnuddin, Rodin, M. A., & Wardani, R. (2024). Pengaruh edukasi dan konseling terhadap perilaku perawatan diri pada penyandang diabetes melitus tipe 2: Literature review. Journal of Nursing Innovation, 3(2), 35–45.

Besemah, N. A., Sartika, R. A. D., & Sauriasari, R. (2021). Effect of Pharmacist Intervention on Medication Adherence and Clinical Outcomes of Type 2 Diabetes Mellitus Outpatients in Primary Healthcare in Indonesia. Journal of Research in Pharmacy Practice, 9(4), 186–195. https://doi.org/10.4103/jrpp.JRPP_20_59

DiPiro, J. T., Schwinghammer, T. L., & Terry, L. S. (2023). DiPiro’s Pharmacotherapy Handbook (11th ed.). McGraw-Hill Education.

Emeka, P. M., Almunjem, M. F., Pharm, D., Rasool, S. T., & Kamil, N. (2020). Evaluation of Counseling Practices and Patient ’ s Satisfaction Offered by Pharmacists for Diabetics Attending Outpatient Pharmacies in Al Ahsa. Journal of Patient Experience, 7(3), 338–345. https://doi.org/10.1177/2374373519846945

Fajriansyah, Iskandarsyah, A., Puspitasari, I. M., & Lestari, K. (2020). Impact of pharmacist counseling on health-related quality of life of patients with type 2 diabetes mellitus : a cluster randomized controlled study. Journal of Diabetes & Metabolic Disorders, 19, 675–682.

Fatiha, C. N., Apoteker, K., Darah, K. G., & Questionnaire, M. A. (2021). Peningkatan Kepatuhan Minum Obat Melalui Konseling Apoteker pada Pasien Diabetes Mellitus Tipe 2 di Puskesmas Halmahera Kota Semarang. JPSCR: Journal of Pharmaceutical Science and Clinical Research, 4(1), 41–48. https://doi.org/10.20961/jpscr.v6i1.39297

Gulo, P. F., Suandy, Hidayat, A., & Neswita, E. (2024). Dampak Edukasi Obat bagi Pemahaman dan Perilaku Pasien DM II di RSUP H. Adam Malik Medan. Journal of Multidisciplinary Research and Development, 6(5), 1443–1448.

Istiqomah, I., Sari, D. R., Fauzi, F. M., & Wutsqa, Y. U. (2025). Efek Konseling Farmasi pada Kualitas Hidup dan Gula Darah Pasien Diabetes Melitus Tipe 2. Journal of Pharmacy and Nutritional Research, 1(1), 50–62.

Jaya, M. K. A., Rahmawati, F., Yasin, N. M., & Ikawati, Z. (2025). Pharmacists perceived barriers in providing counseling services to ambulatory type 2 diabetes mellitus patients: A qualitative phenomenological study in Bali, Indonesia. Journal of Applied Pharmaceutical Science, 15(9), 85–96. https://doi.org/10.7324/JAPS.2025.233011

Khairunnisa, Rawitri, K., Wiryanto, & Wahyuni, S. (2021). Pengaruh Asuhan Kefarmasian Terhadap Outcome Klinis dan Kualitas Hidup pada Pasien Diabetes Melitus Tipe 2. Jurnal Farmasi Indonesia, 13(2), 118–128.

Kutluay, N. B., Bektay, M. Y., Sekerci, B. S., & Sekerci, A. (2025). Impact of clinical pharmacist integration on diabetes management : a prospective cohort. BMC Health Services Research, 25(107), 1–10. https://doi.org/10.1186/s12913-025-12233-7

Muhammad, N., Kosegeran, E., & Djalil, R. H. (2024). Pengaruh Edukasi Kesehatan Terhadap Pengetahuan Kepatuhan Minum Obat Pasien Diabetes Melitus Tipe 2 Di Rumah Sakit Tk II Robert Wolter Mongisidi Manado. OBAT: Jurnal Riset Ilmu Farmasi Dan Kesehatan, 2(1), 43–53.

Mulyaningsih, Ardika, N. A., Wahyuni, & Hermawati. (2025). Self-Management Counseling Increases Compliance in Diabetes Mellitus Patients. Jurnal Berita Ilmu Keperawatan, 18(2), 278–285.

Nguyen, T. H., Tran, T. T. T., Nguyen, N. K., Diep, H. G., Vo, S. D., & Taxis, K. (2022). A randomized controlled trial of a pharmacist-led intervention to enhance knowledge of Vietnamese patients with type 2 diabetes mellitus. International Journal of Pharmacy Practice, 30(August 2021), 449–456.

Padmasari, S., Azizah, F. N., & Larasati, N. (2021). Edukasi home pharmacy care terhadap kepatuhan dan kontrol glukosa darah pada pasien diabetes melitus. Jurnal Sains Farmasi & Klinis, 8(2), 182–189. https://doi.org/10.25077/jsfk.8.2.182-189.2021

Panjaitan, R. Z. S., Sari, H. N., & Octavia, Y. (2025). The Effect of Counselling on Adherence in Patients with Type 2 Diabetes Mellitus at the Internal Medicine Polyclinic of dr. Ferdinand Lumbantobing General Hospital Sibolga. Journal of Pharmaceutical and Sciences, 8(3), 1713–1720.

Patil, N. B., Patil, P. P., Javadekar, N., & Pawar, S. (2025). Bridging the Adherence Gap: Innovative Counseling Strategies and their Effect on HbA1c in Type 2 Diabetes Patients. Journal of Young Pharmacists, 17(2), 412–419. https://doi.org/10.5530/jyp.20251682

Peralta, F. G.-, Pérez, J. A. F., Molinero, A., Barrancos, I. M. S., Martínez, E. A., Martínez-, P., Diab, O., & Care, R. (2021). Adherence to antidiabetic treatment and impaired hypoglycemia awareness in type 2 diabetes mellitus assessed in Spanish community pharmacies : the ADHIFAC study. BMJ Open Diab Res Care 2021;9:E002148., 9, 1–10. https://doi.org/10.1136/bmjdrc-2021-002148

Rahman, Z., Atrie, U. Y., Pujiati, W., & Ernawati, E. (2025). Edukasi Upaya Peningkatan Kualitas Hidup Pasien Diabetes Melitus Tipe 2. Jurnal Medika: Medika, 4(3), 313–318.

Regitha, D., Sari, P., Wahid, R. A. H., & Ambarsari, D. W. (2025). Knowledge and Medication Adherence among Type 2 Diabetes Mellitus Patients : A Cross-Sectional Study in Yogyakarta , Indonesia. Indonesian Journal of Pharmaceutical Education (e-Journal), 5(3), 311–324. https://doi.org/10.37311/ijpe.v5i3.33231

Santoso, A. H., Ernawati, E., Tan, S. T., Wijaya, D. A., & Nathaniel, F. (2023). Community Service Activities - Counseling And Random Blood Sugar Screening ( Type 2 Diabetes Mellitus ). Cakrawala: Jurnal Pengabdian Masyarakat Global, 2(2), 110–118.

Saputri, G. Z., Sari, O. M., & Akrom, A. (2022). Modified brief counseling-5A , motivational SMS on medication- taking behavior and compliance among diabetic patients. International Journal of Public Health Science (IJPHS), 11(3), 852–860. https://doi.org/10.11591/ijphs.v11i3.21348

Syafitri, I. W., Yasin, N. M., & Sari, I. P. (2023). Pengaruh Edukasi oleh Apoteker dengan Metode Brief Counseling terhadap Pengetahuan , Kepatuhan dan Glukosa Darah Pasien DM Tipe 2 di Puskesmas Kabupaten Pemalang. JMPF Vol., 11(1), 12–22.

Tanjung, D. I. U., Razoki, Karo, R. M. B., & Neswita, E. (2022). Pengaruh Konseling Obat Terhadap Kepatuhan Pasien Diabetes Melitus Tipe 2 di Apotek Reza Farma. Journal Health and Science ) (Gorontalo Journal Health & Science Community, 6(2), 213–221.

Wibowo, M. I. N. A., Setiawan, D., Ikhwaniati, N. D., & Sukma, F. A. (2020). Pengaruh Konseling dan Alat Bantu Pengingat Pengobatan terhadap Kepatuhan Minum Obat dan Outcome Klinik Pasien Diabetes Melitus dan Hipertensi. Jurnal Ilmu Kefarmasian Indonesia, 18(2), 169–176.