Enhancing diabetes care by adding a pharmacist to the primary care team

Ip, Eric J.; Shah, Bijal M.; Yu, Junhua; Chan, James; Nguyen, Lynda T.; Bhatt, Deempal. C.

doi:10.2146/ajhp120238

Cited by 79 publications

(99 citation statements)

References 25 publications

(29 reference statements)

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“…Ip et al reported that intervention by pharmacists in primary care led to a decrease of HbA1c level after 12 months. 8) This report supports the need for pharmacists to participate in the treatment of ambulatory diabetic patients. In addition, Spence et al reported that improvement of adherence and a decrease of HbA1c level were achieved by faceto-face counseling of patients with poor glycemic control.…”

Section: Introductionsupporting

confidence: 61%

Effect of Patient Education for Diabetic Outpatients by a Hospital Pharmacist: A Retrospective Study

Ichiki

Kobayashi²,

Kubota³

et al. 2016

YAKUGAKU ZASSHI

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The number of patients with diabetes continues to increase in Japan, which means that education in disease management is important. However, there have been few investigations into the importance of hospital pharmacists performing outpatient education for diabetes mellitus in Japan. In the diabetes outpatient department of Kitakyushu City Moji Hospital, a pharmacist commenced patient education using check sheets before patients saw the physicians from 2012. We divided the patients into groups with an increase or decrease of hemoglobin A1c (HbA1c) level after 6 months from the start of patient education. To assess the factors related to a decrease of HbA1c level, we compared background factors, and laboratory values between these two groups. In the patients whose HbA1c level decreased, the level was high at the start of patient education and they had less knowledge about their medications. To evaluate the impact of this patient education, we compared HbA1c values before patient education and after 6 months to determine the eŠect of providing education in the diabetes outpatient department. In the HbA1c8％ group, the HbA1c level decreased signiˆcantly during 6 months of patient education. These results suggest that patient education by hospital pharmacists can be eŠective if HbA1c level is high at the start of education. This is theˆrst report about the usefulness of patient education by a hospital pharmacist for improvement of HbA1c level in diabetic outpatients in Japan.

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Section: Introductionsupporting

confidence: 61%

Effect of Patient Education for Diabetic Outpatients by a Hospital Pharmacist: A Retrospective Study

Ichiki

Kobayashi²,

Kubota³

et al. 2016

YAKUGAKU ZASSHI

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“…Projected long-term cardiovascular risk was also significantly decreased in the intervention arm receiving pharmacist care. In this model, uncontrolled diabetics with A1c ≥7% were referred by the primary care team to the pharmacist for more stringent follow-up; the pharmacist performed pharmacotherapy adjustments under collaborative practice agreement (Ip et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Impact of Pharmacist Care in a Shared Medical Appointment Model for the Management of Type 2 Diabetes in a Micronesian Population

Tan

Juárez

Haumea

et al. 2014

CALIF J HEALTH PROMOT

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More than 25 million people have diabetes in the United States and its complications make it a leading cause of death. Pacific Islanders, specifically Micronesians, experience even higher rates of diabetes, and pharmacist care for these individuals may improve health outcomes. Objective: To better address health disparities in this population, a health center serving Hawaii Island added clinical pharmacy services into their shared medical appointment program for diabetes management. Methods: Standard care (n= 21) consisted of weekly education sessions for patients provided by a multi-disciplinary team, after which patients had one-on-one appointments with a primary care provider if they met threshold clinical criteria. The intervention group (n=36) received the same services, plus a medication management service provided by a pharmacist during the one-on-one appointments. Results: There was no statistically significant difference between the pharmacist care and standard care groups on clinical measures including glycosylated hemoglobin, low density lipoprotein and blood pressure at the end of the eighteenmonth intervention period. Conclusion: Pacific Islanders face unique health care challenges including low socioeconomic status, language barriers and differences in cultural perceptions of health care. The value of clinical pharmacy has been well-documented in the literature but further study of the role and impact of these services is warranted for high-risk populations.

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“…In terms of diabetes management, studies have shown that CMM leads to significant reductions in hemoglobin A1c compared to control arms with estimated treatment differences ranging from -0.4% to -1.7%. [14][15][16][17][18] Moreover, several studies have demonstrated CMM's positive impact on all-or-none diabetes composite scores that involve achievement of several important treatment goals including smoking cessation, daily aspirin use, and meeting A1c, low density lipoprotein (LDL), and blood pressure goals. [5][6][7]15 Some studies of well-adopted CMM services have even demonstrated a positive impact on lowering patient total cost of care by decreasing hospitalizations and other acute care utilization.…”

Section: Introductionmentioning

confidence: 99%

Making the economic value proposition for pharmacist comprehensive medication management (CMM) in primary care: A conceptual framework

Tripicchio

Urick

Easter

et al. 2020

Research in Social and Administrative Pharmacy

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Introduction: Comprehensive medication management (CMM) is a patient care process provided by clinical pharmacists in primary care settings that ensures optimal use of medications with timely followup. Despite widespread evidence that shows CMM improves clinical and medication-related outcomes, pharmacist CMM services often fail to be adopted into U.S. primary care settings. Objective: This study presents a conceptual framework linking outcomes of pharmacist-delivered CMM services in primary care settings to financial benefits for both primary care practices investing and implementing CMM and health plans providing coverage of CMM services. Methods: A narrative literature review was performed in PubMed and the gray literature to identify financing opportunities that justify the coverage of CMM by third party health plan administrators or the implementation of CMM by primary care practices. Financing elements that could be impacted by pharmacist-led CMM outcomes, namely higher achievement of medication-related quality measures and reduction of total costs of care, were recorded and utilized to develop the conceptual framework. Results: The framework suggests that CMM may provide economic benefits to health plans and care practices by (1) increasing market competitiveness through higher quality ratings, accreditation recognition, lower premiums and plan bids, and increased patient satisfaction; and (2) increasing revenue through quality bonus payments, shared savings agreements, and fee-for-service reimbursement. Conclusions: The alignment of economic benefits that can be realized through CMM advances a strong value proposition for greater adoption of CMM in the United States' primary care system. Future application of this study's conceptual framework could include use as an advocacy tool amongst pharmacy associations or as a tool for individuals seeking buy-in for CMM services.

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Enhancing diabetes care by adding a pharmacist to the primary care team

Abstract: The addition of a pharmacist to an HMO primary care team improved short-term surrogate markers as well as long-term cardiovascular risk in adult patients with type 2 diabetes.

Cited by 79 publications

References 25 publications

Effect of Patient Education for Diabetic Outpatients by a Hospital Pharmacist: A Retrospective Study

Effect of Patient Education for Diabetic Outpatients by a Hospital Pharmacist: A Retrospective Study

Impact of Pharmacist Care in a Shared Medical Appointment Model for the Management of Type 2 Diabetes in a Micronesian Population

Making the economic value proposition for pharmacist comprehensive medication management (CMM) in primary care: A conceptual framework

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