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

Abstract

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.