Providing diabetes education and care to underserved patients in a collaborative practice at a utah community health center.

Many underserved patients in Utah lack insurance coverage for health care and prescription drugs but are provided medical care in community health centers (CHCs). Before June 2000, comprehensive pharmacy services were not provided to these patients at a Utah CHC. As part of a Health Resources and Services Administration grant, a collaborative agreement between the University of Utah College of Pharmacy and Utah CHCs was established so that a faculty clinician who is a certified diabetes educator (CDE) could provide diabetes education and care to underserved patients. The College of Pharmacy faculty clinician (pharmacist CDE) collaborated with physicians and midlevel practitioners to provide diabetes education and care for 176 patients. In addition to initial diabetes education, the pharmacist CDE provided continuing disease management by providing information and feedback to patients and recommendations to providers. The pharmacist CDE conducted continuing chart reviews to track certain parameters, such as laboratory test results for hemoglobin A 1c (A1C) and lipid levels, and blood pressure. Patients were followed for 1-3 years. The same outcome data were also collected for 176 patients with diabetes mellitus in another CHC clinic to provide a comparison group. Total cholesterol, low-density lipoprotein cholesterol, A1C, and triglyceride levels declined significantly from baseline at both sites. However, more patients who were provided care by the pharmacist CDE reached the American Diabetes Association A1C target goal of below 7%.