Pharmacist membership in a medical group's diabetes health management program.

PURPOSE: An evaluation of the effectiveness of a program at achieving improved glycemic control, lipid levels, and adherence to preventive care measures in diabetes mellitus patients was conducted.
SUMMARY: An interdisciplinary diabetes health management program (DHMP) was implemented, which included physicians, clinical pharmacists, registered nurses, and registered dieticians. The patients are seen by a clinical pharmacist with the option of individual or group visits with other members of the multidisciplinary team. Clinical pharmacist interventions include education and comprehensive medication management through collaborative practice agreements held with physicians. The collaborative agreements allow the clinical pharmacist to initiate, adjust, or discontinue pharmacotherapy and order pertinent laboratory tests and podiatry referrals that are within the scope of the medication management protocol. A retrospective review was conducted of the 707 patients enrolled in the program between April 2002 and April 2004. The mean +/- S.D. number of days between baseline and follow-up values was 140 +/- 62. Eighty-four percent of the enrolled patients were diagnosed with type 2 diabetes mellitus, 69% met the National Cholesterol Education Program's criteria for metabolic syndrome, and 51% were male. The mean glycosylated hemoglobin (HbA(1c)) value dropped significantly, and the percentage of patients who were at or below the American Diabetes Association's established HbA(1c) goal of < or = 7% increased significantly. Lipid values for enrolled patients improved, with the percentage achieving a low-density-lipoprotein cholesterol concentration of <100 mg/dL increasing from 25% to 44% [corrected] Adherence to preventive care measures (e.g., annual eye and foot examinations) also significantly improved from baseline to follow-up.
CONCLUSION: Involvement of pharmacists in an interdisciplinary DHMP has improved patient care.