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Outcomes of a pharmacist‐managed clinic for underserved persons with unmanaged type 2 diabetes mellitus
Author(s) -
Lefebvre Ashley L.,
Zullo Andrew R.,
DapaahAfriyie Ruth,
Collins Christine M.,
Elsaid Khaled A.
Publication year - 2018
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/jppr.1349
Subject(s) - medicine , pharmacist , diabetes mellitus , blood pressure , cohort , type 2 diabetes , type 2 diabetes mellitus , repeated measures design , pediatrics , pharmacy , endocrinology , family medicine , statistics , mathematics
Background A multidisciplinary approach is recommended for the management of type 2 diabetes mellitus ( DM ). Aim To evaluate the impact of a pharmacist intervention on haemoglobin A1c (HbA 1c ), systolic blood pressure ( SBP ), diastolic blood pressure ( DBP ), and diabetes‐related hospitalisations in an underserved cohort with unmanaged type 2 DM . Methods This analysis was a retrospective cohort study. Criteria for inclusion were persons with unmanaged type 2 DM defined as HbA 1c values ≥8% at time of enrolment, ≥18 years old, and enrolment in a pharmacist‐managed clinic for ≥12 months. Pre‐ and post‐intervention differences in HbA 1c , SBP and DBP values were assessed using repeated measures analysis of variance ( ANOVA ). The risk of diabetes‐related hospitalisations was estimated during the 12 months prior and during the 12 months post‐intervention, and the relative risk ( RR ) was calculated. Results Mean HbA 1c values at 3, 6 and 12 months post‐intervention were lower than baseline values (p < 0.05). There was no significant difference in mean HbA 1c values at 6 or 12 months compared to 3 months post intervention. Mean SBP values at 3, 6 and 12 months were lower than baseline (p < 0.05). Likewise, mean DBP values at 6 and 12 months were lower than baseline (p < 0.05). The estimated RR of diabetes‐related hospitalisations was 0.40 (95% CI : 0.20–0.83; p = 0.013). Conclusion Enrolment in a pharmacist‐managed diabetes program was associated with a significant reduction in HbA 1c , SBP and DBP and reduction in risk of diabetes‐related hospitalisations in an underserved cohort of patients with diabetes over a 12‐month period.