D-PATH STUDY

Background:

Type 2 diabetes is common in Alberta and many people don’t reach targets for A1C, blood pressure, and cholesterol. This study will test whether a structured, pharmacist-led care pathway—using a simple computer decision-support tool and shared decision-making—helps adults with poorly controlled type 2 diabetes lower A1C and improve heart-health risk. The main aim is to compare change in A1C over 6 months between the new pathway and usual care. Secondary aims include changes in calculated cardiovascular (CV) risk, blood pressure, LDLcholesterol, completion of routine diabetes checks, vaccinations, patient satisfaction, and the extent of shared decision-making.

Who can participate? 

Adults (18+) in Alberta with type 2 diabetes whose A1C is above target (>7%). People with type 1 or gestational diabetes, those already at their personal A1C target, pregnant individuals, or people unable to consent/attend follow-ups are not eligible.

What does the study involve?

After consent and a baseline questionnaire, participants are randomly assigned to one of two groups:

Intervention group: 

Ongoing pharmacist care using a step-by-step tool based on Canadian guidelines. It calculates personal cardiovascular risk (EPI·RxISK™), sets individualized targets, suggests medication/lifestyle options, and books follow-ups every 6 weeks for 6 months. Pharmacists can adjust or prescribe medicines and order labs within their scope, and they share plans with the participant’s primary care team.

Control group: 

Their pharmacist gathers current diabetes information and gives them a letter with their A1C to take to their family doctor or nurse practitioner. They get a brief lifestyle visit at 3 months and a final visit at 6 months. After the study, they’re offered the full pharmacist pathway.

What are the possible benefits and risks of participating? 

Possible benefits: 

Closer follow-up, clearer treatment plan, potential improvements in A1C and overall CV risk, and help staying on track with screenings and vaccinations.

Possible risks: 

More frequent visits and blood tests may cause inconvenience, brief anxiety, needle discomfort, or (rarely) infection from blood draws. Participants can withdraw at any time. 

Where is the study run from? 

In community pharmacies across Alberta, Canada.