Objectives
Medication non-adherence poses a significant barrier to the effective treatment of diabetes. The objective of this study was to determine how effectively pharmacists could identify and resolve non-adherence issues in a clinical setting.

Methods
The study was conducted at several pharmacies co-located within endocrinology clinics. In this setting, pharmacists work closely with the multidisciplinary team and have access to patients electronic medical records and lab values. Patients were seen by a pharmacist for a comprehensive medication review prior to their endocrinologist appointments. Patients who missed a medication dose once weekly or more were flagged as non-adherent. Causes of non-adherence and the pharmacists recommendations were documented.

Results
Between January and April 2016, 2604 patients were seen and 303 were identified as non-adherent. In 95.4% of cases (n=289), the pharmacist was able to provide counseling or propose a solution, leading to a resolution in 82% (n=248). The most common cause of non-adherence was due to a patient misunderstanding the benefits or proper use of their medications (Figure 1). Pharmacist counseling was often able to overcome this barrier. Common counseling topics included the benefits of statin and RAAS therapy; and areas of skill training included injection technique and insulin kinetics

Conclusion
Pharmacists employed in a clinical setting can accurately identify non-adherence, and its related issues. Pharmacist counseling was an effective intervention in overcoming non-adherence. As Canadian pharmacists assume a growing responsibility in the care of diabetes patients, understanding their optimal area of effectiveness will allow better application of their time.