Jordan L Schultz1,2, Kathleen E Horner1, Deanna L McDanel1,3, Michelle L Miller1, Randi L Beranek1, Ryan B Jacobsen1,2, Nichole J Sly4, Aaron C Miller5, Lisa A Mascardo1. 1. 1 Department of Pharmaceutical Care, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA. 2. 2 Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA. 3. 3 The University of Iowa College of Pharmacy, Iowa City, IA, USA. 4. 4 Department of Pharmacy, Froedtert Hospital, Milwaukee, WI, USA. 5. 5 Department of Business and Economics, Cornell College, Mount Vernon, IA, USA.
Abstract
BACKGROUND: This study analyzed the impact of a pharmacist-managed diabetes clinic on clinical outcomes compared to usual care received from primary care providers (PCPs). This comparison may more definitively demonstrate the value of pharmacist management of chronic disease states. METHODS: Retrospective observational cohort study conducted in patients referred to a pharmacist-managed pharmacotherapy (PT) clinic from July 2009 to October 2014. RESULTS: For the primary outcome, the absolute change in A1c during the usual care phase was +1.53% (95% confidence interval [CI]: 1.10-1.96, P < .0001) versus an absolute change of -1.63% (95% CI: -1.28 to -1.97, P < .0001) in the intervention phase. For secondary outcomes, diabetes-related hospitalizations (10 vs 6, P = .104) and emergency room (ER) visits (27 vs 8, P = .049) decreased in the intervention phase compared to the usual care phase. The rate of diabetes-related interventions made per patient per year in the usual care phase was 2.7 versus 11.1 in the intervention phase ( P < .0001). CONCLUSION: Patients referred to the PT clinic had worsening blood glucose control prior to referral, and their control improved after referral to the clinic. Furthermore, there was an improvement in all diabetes-related outcomes in the intervention phase compared to the usual care phase.
BACKGROUND: This study analyzed the impact of a pharmacist-managed diabetes clinic on clinical outcomes compared to usual care received from primary care providers (PCPs). This comparison may more definitively demonstrate the value of pharmacist management of chronic disease states. METHODS: Retrospective observational cohort study conducted in patients referred to a pharmacist-managed pharmacotherapy (PT) clinic from July 2009 to October 2014. RESULTS: For the primary outcome, the absolute change in A1c during the usual care phase was +1.53% (95% confidence interval [CI]: 1.10-1.96, P < .0001) versus an absolute change of -1.63% (95% CI: -1.28 to -1.97, P < .0001) in the intervention phase. For secondary outcomes, diabetes-related hospitalizations (10 vs 6, P = .104) and emergency room (ER) visits (27 vs 8, P = .049) decreased in the intervention phase compared to the usual care phase. The rate of diabetes-related interventions made per patient per year in the usual care phase was 2.7 versus 11.1 in the intervention phase ( P < .0001). CONCLUSION:Patients referred to the PT clinic had worsening blood glucose control prior to referral, and their control improved after referral to the clinic. Furthermore, there was an improvement in all diabetes-related outcomes in the intervention phase compared to the usual care phase.
Entities:
Keywords:
clinical outcomes; medication therapy management; pharmacists; type 2 diabetes mellitus; usual care
Authors: Sultan M Alghadeer; Bashayr Alsuwayni; Abdulmohsen K Almuwayjid; Mohammed S Almadi; Abdullah M Mubarak; Rawan M Bin Khunayn; Mohamed N Al-Arifi Journal: Medicina (Kaunas) Date: 2021-12-22 Impact factor: 2.430