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Ann Pharmacother. 2012 Mar;46(3):353-7. doi: 10.1345/aph.1Q564. Epub 2012 Mar 6.

Impact of clinical pharmacist intervention on diabetes-related outcomes in a military treatment facility.

Author information

1
Department of Pharmacy, Womack Army Medical Center, Fort Bragg, NC, USA. stephanie.a.wallgren@us.army.mil

Abstract

BACKGROUND:

Clinical pharmacist management of patients with diabetes has been well justified, but there is a lack of research that evaluates the impact of pharmacist-managed diabetes care versus standard medical care on American Diabetes Association (ADA) treatment goals other than hemoglobin A(1c) (A1C).

OBJECTIVE:

To evaluate the reduction in A1C, blood pressure, and low-density lipoprotein cholesterol (LDL-C) for patients with diabetes whose care was managed by a clinical pharmacist and compare these values to those of a cohort of patients whose care was managed by primary care providers. The difference in percentage of patients attaining ADA treatment goals between the 2 groups was also evaluated.

METHODS:

This retrospective chart review identified 98 diabetic patients managed by a clinical pharmacist with at least 2 A1C measurements between September 15, 2008, and March 15, 2011. The Military Health System Population Health Portal was used to identify a similar group of patients with diabetes managed by their primary care provider (N = 90). The Armed Forces Health Longitudinal Technology Application was used to collect baseline data and the most recent measurements for A1C, blood pressure, LDL-C, and documented immunizations.

RESULTS:

The pharmacist group saw positive improvements in all primary end points, including a 1.6% reduction in A1C, a 9-mm Hg and 1.4-mm Hg reduction in systolic and diastolic blood pressure, respectively, and a 16.3-mg/dL reduction in LDL-C. Conversely, the control group had an increase of 0.8% in A1C and 1.5 mm Hg in diastolic blood pressure. Reductions in systolic blood pressure and LDL-C were much less robust than in the pharmacist group (1.6 mm Hg and 5.2 mg/dL, respectively). Overall, patients in the pharmacist group were more likely to achieve ADA treatment goals.

CONCLUSION:

Pharmacist management of patients with diabetes significantly reduces A1C and allows more patients to meet ADA treatment goals. A clinical pharmacist-run diabetes clinic can provide numerous clinical benefits to patients.

PMID:
22395249
DOI:
10.1345/aph.1Q564
[Indexed for MEDLINE]

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