Emily M Hawes1,2, Erika Lambert3,4, Alfred Reid5, Gretchen Tong6,5, Mark Gwynne7,5. 1. Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC emily_hawes@med.unc.edu. 2. UNC Eshelman School of Pharmacy, Chapel Hill, NC. emily_hawes@med.unc.edu. 3. UNC Medical Center, Chapel Hill, NC. 4. UNC Eshelman School of Pharmacy, Chapel Hill, NC. 5. Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC. 6. UNC Family Medicine Center, Chapel Hill, NC. 7. UNC Health Alliance, Chapel Hill, NC.
Abstract
PURPOSE: Results of a study evaluating quality-of-care, financial, and patient satisfaction outcomes of pharmacist-conducted telehealth visits for diabetes management and warfarin monitoring are reported. METHODS: A retrospective pre-post study was conducted to determine the impact of an electronic visit (e-visit) program targeting 2 groups of outpatients: adults with uncontrolled diabetes and warfarin-treated adults performing patient self-testing (PST) for monitoring of International Normalized Ratio (INR) values. RESULTS: A total of 36 patients participated in the e-visit program during the 2-year study period. Among warfarin-treated patients, the percentage of INR values in the desired range increased relative to preenrollment values (from 62.5% to 72.7%, p = 0.07), and the frequency of extreme INR values (values of <1.5 or >5.0) decreased (from 4.8% to 0.01%, p = 0.01); the margin per patient was $300 during the first year and $191 annually thereafter. In the diabetes group, a decrease from baseline in glycosylated hemoglobin values of 3.4 percentage points was observed at 5.7 months after enrollment (p < 0.001), with significant improvements in frequencies of statin use, aspirin use, and blood pressure control; the margin was $100 per patient. The overall median patient satisfaction survey score was 39 of 40. CONCLUSION: An online e-visit model for warfarin monitoring was an efficient, safe, and cost-effective method for implementing PST. Pharmacist-led management of diabetes through e-visits, often in combination with in-person visits, generated revenue while significantly improving clinical outcomes.
PURPOSE: Results of a study evaluating quality-of-care, financial, and patient satisfaction outcomes of pharmacist-conducted telehealth visits for diabetes management and warfarin monitoring are reported. METHODS: A retrospective pre-post study was conducted to determine the impact of an electronic visit (e-visit) program targeting 2 groups of outpatients: adults with uncontrolled diabetes and warfarin-treated adults performing patient self-testing (PST) for monitoring of International Normalized Ratio (INR) values. RESULTS: A total of 36 patients participated in the e-visit program during the 2-year study period. Among warfarin-treated patients, the percentage of INR values in the desired range increased relative to preenrollment values (from 62.5% to 72.7%, p = 0.07), and the frequency of extreme INR values (values of <1.5 or >5.0) decreased (from 4.8% to 0.01%, p = 0.01); the margin per patient was $300 during the first year and $191 annually thereafter. In the diabetes group, a decrease from baseline in glycosylated hemoglobin values of 3.4 percentage points was observed at 5.7 months after enrollment (p < 0.001), with significant improvements in frequencies of statin use, aspirin use, and blood pressure control; the margin was $100 per patient. The overall median patient satisfaction survey score was 39 of 40. CONCLUSION: An online e-visit model for warfarin monitoring was an efficient, safe, and cost-effective method for implementing PST. Pharmacist-led management of diabetes through e-visits, often in combination with in-person visits, generated revenue while significantly improving clinical outcomes.
Authors: Oliver T Nguyen; Amir Alishahi Tabriz; Jinhai Huo; Karim Hanna; Christopher M Shea; Kea Turner Journal: J Med Internet Res Date: 2021-05-05 Impact factor: 5.428
Authors: Jelena Lewis; Tiffany Nguyen; Hana Althobaiti; Mona Y Alsheikh; Brad Borsari; Suzanne Cooper; David S Kim; Enrique Seoane-Vazquez Journal: Innov Pharm Date: 2019-10-31