Literature DB >> 27000168

Federal Bureau of Prisons clinical pharmacy program improves patient A1C.

J Tyler Bingham, Jeff J Mallette.   

Abstract

OBJECTIVE: The Federal Bureau of Prisons (BOP) currently has over 13,000 patients with diabetes and has placed an emphasis on preventing and delaying the onset or progression of diabetes-related complications. In an ongoing effort to improve patient outcomes, BOP has implemented a nationwide, dynamic system of pharmacist-delivered patient care services via pharmacist clinicians working under the auspices of a physician-pharmacist collaborative practice agreement (CPA).
SETTING: The BOP Clinical Pharmacy Workgroup targets improved patient outcomes via oversight and support of institution pharmacist clinicians and physicians in establishing and maintaining physician-pharmacist CPAs. A primary emphasis is diabetes and the pharmacist-run clinic clinical outcomes data are presented. PRACTICE INNOVATION: Seventy (nearly one-half) of eligible BOP pharmacists at 37 institutions offer pharmacist-delivered patient care services via an approved CPA. In total, BOP has 111 active physician-pharmacist CPAs. MAIN OUTCOME MEASURES: Pharmacist-run diabetes clinic outcomes from 5 institutions have been reported to date. A total of 126 patients were enrolled. Patient's hemoglobin A1C, blood pressure, and LDL cholesterol level are measured before (i.e., when accepted in the diabetes clinic) and after pharmacist-delivered care has been provided. The pharmacist-run diabetes clinics reported an average baseline A1C of 10.6% and produced an average outcome decrease in A1C of 2.3% from baseline.
RESULTS: Specific pharmacist clinic interventions found to have the greatest impact are: 1) timely medication adjustment when indicated to help patients meet outcome goals; and 2) timely follow-up after a change in therapy is made (often within 1-2 weeks) with continued medication adjustment when indicated until outcome goal is achieved.
CONCLUSION: BOP pharmacists have become respected and trusted clinicians within the team medicine model. As demonstrated by the pharmacist-run diabetes clinic outcomes, pharmacist clinicians are a valued link to the improvement of patient outcomes in BOP.
Copyright © 2016. Published by Elsevier Inc.

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Year:  2016        PMID: 27000168     DOI: 10.1016/j.japh.2016.01.002

Source DB:  PubMed          Journal:  J Am Pharm Assoc (2003)        ISSN: 1086-5802


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