BackgroundEvidence suggests that patients with type 2 diabetes (T2DM) suffer from a
high rate of “clinical inertia” or “recognition of the problem but failure
to act.” ObjectiveThe aim of this study is to quantify the rate of clinical inertia between two
models of care: Pharmacist-Managed Diabetes Clinic (PMDC) vs. Usual Medical
Care (UMC).MethodsPatients in a university based medical clinic with type 2 diabetes (T2DM)
were analyzed in this retrospective cohort study. Patients were exposed to
either PMDC or UMC. The difference in days to intervention in response to
suboptimal laboratory values and time to achieve goal hemoglobin A1c (A1c),
systolic blood pressure (SBP) and low-density lipoprotein (LDL) was compared
in the two models of care.ResultsA total of 113 patients were included in the analysis of this study, 54
patients were in the PMDC and 59 patients were in the UMC group. Median time
(days) to intervention for A1c values >7% was 8 days and 9 days in the PMDC
and UMC groups, respectively (p>0.05). In patients with baseline A1c values
>8%, median time to achieving A1c<7% was 259 days vs. 403 days in the
PMDC and UMC groups, respectively (p<0.05). Median time to goal SBP was
124 days in the PMDC group and 532 days in the UMC group (p<0.05). Median
time to goal LDL was 412 days in the PMDC group vs. 506 days in the UMC
group (p<0.05).ConclusionsRates of clinical inertia, defined as time to intervention of suboptimal
clinical values, did not differ significantly between patients enrolled in a
PMDC compared to patients with UMC with respect to A1c, SBP and LDL.
Participation in PMDC, however, was associated with achieving goal A1c, SBP,
and LDL levels sooner compared to UMC.
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