Eman Biltaji1, Minkyoung Yoo2, Brandon T Jennings3, Jennifer P Leiser4, Carrie McAdam-Marx5. 1. Department of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, 30 S. 2000 E., Salt Lake City, UT 84112, 801 585 1065, e.biltaji@utah.edu. 2. Department of Economics, University of Utah, 332 S 1400 E, Salt Lake City, UT 84112, 801 581 7481, minkyoung.yoo@pharm.utah.edu. 3. Department of Pharmacy Practice, Shenandoah University Bernard J. Dunn School of Pharmacy, 1460 University Drive, Winchester, VA 22601, 540 665 1282, bjenning2@su.edu. 4. Department of Family & Preventive Medicine, 375 Chipeta Way Rm 201, Salt Lake City, UT 84108, 801 581 7961, Jennifer.Leiser@hsc.utah.edu. 5. Department of Pharmacotherapy, University of Utah, 30 S. 2000 E., Salt Lake City, UT 84112, 801 587 7728, carrie.mcadam-marx@pharm.utah.edu.
Abstract
OBJECTIVES: Pharmacist-led diabetes collaborative drug therapy management (CDTM) has been shown to improve outcomes. Whether such programs are effective specifically in Medicaid patients, who face barriers to access and self-management, has not been well characterized. This pilot study explores glycemic control, utilization and costs associated with pharmacist-led CDTM in a small population of Medicaid patients with type 2 diabetes mellitus (T2DM). METHODS: A pre-post, historical cohort study was conducted of patients with T2DM and Medicaid coverage who received pharmacist-led CDTM in community-based primary clinics between 2008-2012. Outcomes included change in HbA1c, healthcare costs and utilization. RESULTS: This study included 79 Medicaid patients with T2DM who received pharmacist-led CDTM. A subset of 46 patients with Medicaid coverage through an affiliated Medicaid Plan, Healthy U, was identified for additional analysis. At 6-months follow-up, HbA1c was a mean (SD) of 2.0% (2.0) lower than the baseline of 10.3% (1.7). Primary care clinic encounters increased by a mean (median) of 3.4 (2) visits. Per patient health system charges increased by a mean (median) of $4,392 ($620) and the amount paid by Medicaid in the Healthy U subset was $822 ($68) higher in the follow-up period. CONCLUSION: A pharmacist-led diabetes CDTM intervention was associated with improved glycemic control in Medicaid patients, which corresponded with a higher number of primary care visits and observed costs. These findings are consistent with studies not limited to Medicaid, suggesting that CDTM can be effective in type 2 diabetes patients with Medicaid coverage.
OBJECTIVES: Pharmacist-led diabetes collaborative drug therapy management (CDTM) has been shown to improve outcomes. Whether such programs are effective specifically in Medicaid patients, who face barriers to access and self-management, has not been well characterized. This pilot study explores glycemic control, utilization and costs associated with pharmacist-led CDTM in a small population of Medicaid patients with type 2 diabetes mellitus (T2DM). METHODS: A pre-post, historical cohort study was conducted of patients with T2DM and Medicaid coverage who received pharmacist-led CDTM in community-based primary clinics between 2008-2012. Outcomes included change in HbA1c, healthcare costs and utilization. RESULTS: This study included 79 Medicaid patients with T2DM who received pharmacist-led CDTM. A subset of 46 patients with Medicaid coverage through an affiliated Medicaid Plan, Healthy U, was identified for additional analysis. At 6-months follow-up, HbA1c was a mean (SD) of 2.0% (2.0) lower than the baseline of 10.3% (1.7). Primary care clinic encounters increased by a mean (median) of 3.4 (2) visits. Per patient health system charges increased by a mean (median) of $4,392 ($620) and the amount paid by Medicaid in the Healthy U subset was $822 ($68) higher in the follow-up period. CONCLUSION: A pharmacist-led diabetesCDTM intervention was associated with improved glycemic control in Medicaid patients, which corresponded with a higher number of primary care visits and observed costs. These findings are consistent with studies not limited to Medicaid, suggesting that CDTM can be effective in type 2 diabetespatients with Medicaid coverage.
Entities:
Keywords:
Type 2 diabetes; clinical pharmacy service; costs; disparity
Authors: Kathleen T Call; Donna D McAlpine; Carolyn M Garcia; Nathan Shippee; Timothy Beebe; Titilope Cole Adeniyi; Tetyana Shippee Journal: Med Care Date: 2014-08 Impact factor: 2.983