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Professional continuous glucose monitoring: A retrospective cohort study comparing one vs two pharmacist‐driven encounters
Author(s) -
Sherrill Christina H.,
Houpt Christopher T.,
Dixon Elisabeth M.,
Richter Scott J.
Publication year - 2021
Publication title -
journal of the american college of clinical pharmacy
Language(s) - English
Resource type - Journals
ISSN - 2574-9870
DOI - 10.1002/jac5.1427
Subject(s) - pharmacist , medicine , retrospective cohort study , hypoglycemia , demographics , diabetes mellitus , cohort , current procedural terminology , emergency medicine , surgery , pharmacy , insulin , family medicine , demography , sociology , endocrinology
Continuous glucose monitoring (CGM) is a burgeoning approach to measuring glycemia, but the ideal implementation method to optimize outcomes while streamlining clinical procedures is unknown. Furthermore, literature on the impact of pharmacist‐driven professional CGM (proCGM) is lacking. Objectives The primary objective was to compare the change in hemoglobin A1c from baseline to 6 months after pharmacist‐driven proCGM implementation with one vs two proCGM data interpretation encounters. A secondary objective was to describe changes in proCGM report metrics for participants with two encounters. Methods In this retrospective single‐center study, adults with diabetes identified via Current Procedural Terminology code 95250 or 95251 undergoing pharmacist‐driven proCGM implementation with A1c measured within 6 months were included. Patients with additional CGM during the follow‐up period were excluded. Patients were categorized as having one pharmacist‐driven (RPh1) or two pharmacist‐driven (RPh2) encounters for proCGM data analysis for a single sensor. A1c change was analyzed via paired and independent sample t tests and analysis of covariance. ProCGM report metrics were analyzed via paired t tests. Results Sixty‐six RPh1 and 56 RPh2 patients were included. Demographics were similar between groups, except RPh1 patients were younger, had higher body mass index, used less bolus insulin, and had less baseline hypoglycemia ( P = .003, P = .008, P = .002, and P = .001, respectively). Baseline A1c was 8.2% and 8.3% with a mean reduction by 6 months of 0.75% and 0.87% for RPh1 and RPh2, respectively, and a mean follow‐up A1c of 7.4% for both groups. Significant A1c improvement was seen in each group compared with baseline ( P < .001), with no significant difference between groups ( P = .655). There was a significant rise in time in range from the first to second encounter without a significant increase in time below range ( P < .001 and P = .34, respectively). Conclusion Pharmacist‐driven proCGM implementation can significantly improve glycemic control, but no difference was seen in A1c lowering between the two implementation methods.