Implementation of a pharmacist-managed diabetes program

Jennings, Brandon T.; Marx, Carrie McAdam

doi:10.2146/ajhp120252

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…This study demonstrated that a primary care‐based, pharmacist‐led diabetes CDTM programme designed to optimize diabetes medication use in patients with poorly controlled T2DM is associated with improved glycaemic control among Medicaid patients. These results are consistent with other studies that have demonstrated that pharmacist‐led, primary care CDTM is associated with improved glycaemic control . These results are also similar to previous analyses of the overall UUHC CDTM intervention that was not limited by insurance type.…”

Section: Discussionsupporting

confidence: 92%

“…These results are also similar to previous analyses of the overall UUHC CDTM intervention that was not limited by insurance type. A pilot pre–post analysis of N = 111 CDTM patients observed a mean HbA1c reduction of 2.0% from a baseline HbA1c of 10.1% ( P < 0.001) . A larger comparator study (CDTM n = 303) also identified a 2.0% time‐adjusted reduction in HbA1c from a similar baseline of 10.3% …”

Section: Discussionmentioning

confidence: 95%

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Outcomes associated with pharmacist-led diabetes collaborative drug therapy management in a medicaid population

Biltaji

Yoo

Jennings

et al. 2016

J Pharm Health Serv Res

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Objectives Pharmacist-led diabetes collaborative drug therapy management (CDTM) has been shown to improve outcomes. Whether such programs are effective specifically in Medicaid patients, who face barriers to access and self-management, has not been well characterized. This pilot study explores glycemic control, utilization and costs associated with pharmacist-led CDTM in a small population of Medicaid patients with type 2 diabetes mellitus (T2DM). Methods A pre-post, historical cohort study was conducted of patients with T2DM and Medicaid coverage who received pharmacist-led CDTM in community-based primary clinics between 2008-2012. Outcomes included change in HbA1c, healthcare costs and utilization. Results This study included 79 Medicaid patients with T2DM who received pharmacist-led CDTM. A subset of 46 patients with Medicaid coverage through an affiliated Medicaid Plan, Healthy U, was identified for additional analysis. At 6-months follow-up, HbA1c was a mean (SD) of 2.0% (2.0) lower than the baseline of 10.3% (1.7). Primary care clinic encounters increased by a mean (median) of 3.4 (2) visits. Per patient health system charges increased by a mean (median) of $4,392 ($620) and the amount paid by Medicaid in the Healthy U subset was $822 ($68) higher in the follow-up period. Conclusion A pharmacist-led diabetes CDTM intervention was associated with improved glycemic control in Medicaid patients, which corresponded with a higher number of primary care visits and observed costs. These findings are consistent with studies not limited to Medicaid, suggesting that CDTM can be effective in type 2 diabetes patients with Medicaid coverage.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Outcomes associated with pharmacist-led diabetes collaborative drug therapy management in a medicaid population

Biltaji

Yoo

Jennings

et al. 2016

J Pharm Health Serv Res

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“…As part of a health care team, pharmacists, with a more extensive patient contact, can contribute to patient follow-up by providing diabetes education and self-care incentives. Studies have shown significant improvements in HbA1c values, fasting glucose levels, and compliance indicators, when pharmacists are included in the health care team, thereby improving the subjective perception of QoL (Correr, Otuki, 2013;Jennings, Marx, 2012;Collins et al, 2011;Armor et al, 2010;Campbell, 2002).…”

Section: Discussionmentioning

confidence: 99%

Quality of life perception of type 1 diabetic patients treated with insulin analogs and receiving medication review with follow-up in a public health care service from Ponta Grossa-PR, Brazil

Garabeli

Daher

Wiens

et al. 2016

Braz. J. Pharm. Sci.

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Glycemic control in patients with diabetes mellitus type 1 (DM1) reduces the risk of complications but requires a rigorous health care routine. Thus, diabetes education is central to increasing treatment compliance and self-care practices. This study aimed to evaluate the quality of life (QoL) and glycemic control of DM1 patients being treated with insulin analogs and receiving medication review with followup. This was a transversal study that included 110 patients registered at the 3 rd Health Regional of Ponta Grossa-PR, aged ≥ 18 years, and receiving pharmaceutical care for at least 1 year. The Diabetes Quality of Life Measure (DQOL)-Brazil was used to evaluate QoL. The data were statistically analyzed using SPSS version 17.0 with 95% confidence levels. Of the 110 patients, 58.2% were women. The average age was 33.7 years (±10.5), and the average glycated hemoglobin (HbA1c) value was 8% (±1.4). The mean total DQOL-Brazil score was 2.11 (95% confidence interval, 2.02 -2.21). All DQOL-Brazil scores were lower in patients with HbA1c ≤ 8%, indicating a better QoL. Good glycemic control, thus, appears to have a positive influence on the QoL, and pharmaceutical interventions are able to contribute to the achievement of therapeutic targets.Uniterms: Diabetes mellitus type 1/treatment. Diabetes mellitus type 1/treatment/quality of life. Pharmaceutical care. Insulin analogs. Pharmacotherapy follow-up. INTRODUCTIONDiabetes mellitus (DM) is a group of metabolic d i s o r d e r s p r i m a r i l y c h a r a c t e r i z e d b y c h r o n i c hyperglycemia. High glycemic levels are associated with micro-and macrovascular complications leading to damage to, and failure of organs such as the eyes (retinopathy), kidneys (nephropathy), nerves (neuropathy), heart, and blood vessels (ADA, 2016; Braga de Souza et al., 2015;Gross et al., 2002).According to the Diabetes Control and Complications Trial (DCCT), the risk of developing chronic complications is higher in patients with chronically high glycated hemoglobin (HbA1c) levels, and the risk gradually increases with HbA1c levels greater than 7% (Pimazoni Netto et al., 2009). The American Diabetes Association (ADA) defines an HbA1c value < 7% as the acceptable limit for diabetes control. With good glycemic control, patients can be symptom-free, and prevent acute and chronic complications (ADA, 2016;UKPDS, 1999;DCCT, 1988).DM is a chronic condition that requires daily self-care throughout life and has a negative impact on the subjective perception of the quality of life (QoL). However, daily treatment is fundamental to DM control and decreases the risk of complications (Debaty et al., 2008;Wood-Dauphinee, 1999). DM1 therapy includes intensive care demands such as daily blood glucose monitoring, multiple insulin injections, and specific dietary and physical activity recommendations (ADA, 2016). Not understanding all these recommendations and a lack of compliance to treatment leads to a poor glycemic control that can cause severe hyper-or hypoglycemia episodes and chronic complicat...

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“…The EDW contains clinical records for over 1.4 million patients. 12 A recent example of outcomes study in pain used a rule-based NLP algorithm to derive pain scores using EMRs in patients with metastatic prostate cancer. 9 All medical records for each patient, including paper records that were converted into an electronic for-mat, were requested and compiled into a database.…”

Section: Types Of Databases Electronic Medical Record Databasesmentioning

confidence: 99%

Real-World Evidence in Pain Research: A Review of Data Sources

Bellows¹,

Kuo²,

Biltaji³

et al. 2014

Journal of Pain & Palliative Care Pharmacotherapy

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Outcomes research studies use clinical and administrative data generated in the course of patient care or from patient surveys to examine the effectiveness of treatments. Health care providers need to understand the limitations and strengths of the real-world data sources used in outcomes studies to meaningfully use the results. This paper describes five types of databases commonly used in the United States for outcomes research studies, discusses their strengths and limitations, and provides examples of each within the context of pain treatment. The databases specifically discussed are generated from (1) electronic medical records, which are created from patient-provider interactions; (2) administrative claims, which are generated from providers' and patients' transactions with payers; (3) integrated health systems, which are generated by systems that provide both clinical care and insurance benefits and typically represent a combination of electronic medical record and claims data; (4) national surveys, which provide patient-reported responses about their health and behaviors; and (5) patient registries, which are developed to track patients with a given disease or exposure over time for specified purposes, such as population management, safety monitoring, or research.

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Implementation of a pharmacist-managed diabetes program

Cited by 9 publications

References 6 publications

Outcomes associated with pharmacist-led diabetes collaborative drug therapy management in a medicaid population

Outcomes associated with pharmacist-led diabetes collaborative drug therapy management in a medicaid population

Quality of life perception of type 1 diabetic patients treated with insulin analogs and receiving medication review with follow-up in a public health care service from Ponta Grossa-PR, Brazil

Real-World Evidence in Pain Research: A Review of Data Sources

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