Measurement of Pharmacist-Physician Collaborative Care on Therapeutic Inertia in Patients With Type 2 Diabetes

Cowart, Kevin; Emechebe, Nnadozie; Pathak, Rashmi; Abbruzese, Lucas; Hann, J.R.; Lloyd, A.; Roetzheim, Richard G.; Zgibor, Janice C.; Updike, Wendy H.

doi:10.1177/10600280211023492

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…Other studies that looked at the implementation of pharmacist-involved collaborative care in a primary healthcare setting improved several diabetes-related outcomes over 17 months [HbA 1c (7.5% vs. 6.8%), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), and body mass index (30.42 kg/m 2 vs. 30.17 kg/m 2 )] [ 16 ], achieved a longer time in target range for systolic blood pressure compared with control (usual care) [ 17 ] and a shorter time to therapeutic intensification and improvement in A1C goal achievement was observed with pharmacist-physician care compared with usual medical care [ 18 ]. These findings suggest that pharmacist-physician collaborative care may be one of several interventions necessary to improve the diabetes care.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a pharmacist-managed diabetes clinic in high-risk diabetes patients, a randomized controlled trial - “Pharm-MD”

et al. 2022

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Background Diabetes mellitus affects 13% of American adults. To address the complex care requirements necessary to avoid diabetes-related morbidity, the American Diabetes Association recommends utilization of multidisciplinary teams. Research shows pharmacists have a positive impact on multiple clinical diabetic outcomes. Methods Open-label randomized controlled trial with 1:1 assignment that took place in a single institution resident-run outpatient medicine clinic. Patients 18–75 years old with type 2 diabetes mellitus and most recent HbA1c ≥9% were randomized to standard of care (SOC) (continued with routine follow up with their primary provider) or to the SOC + pharmacist-managed diabetes clinic PMDC group (had an additional 6 visits with the pharmacist within 6 months from enrollment). Patients were followed for 12 months after enrollment. Data collected included HbA1c, lipid panel, statin use, blood pressure control, immunization status, and evidence of diabetic complications (retinopathy, nephropathy, neuropathy). Intention-to-treat and per-protocol analysis were performed. Results Forty-four patients were enrolled in the SOC + PMDC group and 42 patients in the SOC group. Average decrease in HbA1c for the intervention compared to the control group at 6 months was − 2.85% vs. -1.32%, (p = 0.0051). Additionally, the odds of achieving a goal HbA1c of ≤8% at 6 months was 3.15 (95% CI = 1.18, 8.42, p = 0.0222) in the intervention versus control group. There was no statistically significant difference in the remaining secondary outcomes measured. Conclusions Addition of pharmacist managed care for patients with type 2 diabetes mellitus is associated with significant improvements in HbA1c compared with standard of care alone. Missing data during follow up limited the power of secondary outcomes analyses. Trial registration ClinicalTrials.gov, ID:NCT03377127; first posted on 19/12/2017.

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Section: Discussionmentioning

confidence: 99%

Efficacy of a pharmacist-managed diabetes clinic in high-risk diabetes patients, a randomized controlled trial - “Pharm-MD”

et al. 2022

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“…The co-visit model not only reduces the burden placed on PCPs to manage chronic disease states and expands patient access, but also results in improved health outcomes, such as improvement in hemoglobin A1c in patients with type 2 DM 3,4 . Previous studies have found that the co-visit model generated 4924.41 dollars in additional income over 14 half-days, allowed providers to see, on average, 1.3 additional patients per half day compared to individual visits, and justified the addition of one full-time equivalent pharmacist position 1,2,9 .…”

Section: Introductionmentioning

confidence: 99%

Improving Patient Access to Primary Care Providers Using a Pharmacist-Physician Co-Visit Model

Palandri¹,

Raber²,

Tak³

et al. 2023

Innov Pharm

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Background: Implementation of a clinical pharmacist in the primary care setting can offset provider time spent managing chronic diseases using Collaborative Practice Agreements (CPAs). The pharmacist-physician co-visit model presents an opportunity for pharmacists to increase patient access to their primary care provider (PCP). Studies of the co-visit model show that co-visits increase clinic efficiency by allowing the PCP to see additional patients and achieve more health care goals compared with independent visits. Objectives: The aim of this study was to increase patient access to their PCP by utilizing a pharmacist-physician co-visit model at the Madsen Health Center Family Medicine (MHC FM) Clinic. The primary outcome was to identify the number of co-visits completed compared to the number of possible co-visits, and the number of appointment slots made available. The secondary outcomes were to track the time spent with patients and to obtain provider feedback via a survey. Methods: The co-visit model was implemented as a 4-month pilot study at the MHC FM Clinic. Complex care appointments lasting 40 minutes were selected based on inclusion and exclusion criteria. Potential co-visit appointments were identified one week prior then provider consent was obtained to change the appointment into two separate 20-minute visits. Schedules were reviewed to determine if the appointment slot opened by the co-visit was filled by another patient. Upon completion of the study, a survey was distributed to providers to collect feedback. Results: A total of five co-visits were completed out of a possible 19 (26%). All the appointments made available were filled by another patient. On average, the provider and pharmacist spent 15 and 14 minutes with the patient, respectively. Conclusion: Implementation of the physician-pharmacist co-visit model increased the availability of the PCP to see more patients without disrupting clinic workflow and provider schedules.

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Factors influencing primary care organization commitment to technical assistance for pharmacist clinical services integration

Mulrooney¹,

Smith²,

Sobieraj³

et al. 2022

Journal of the American Pharmacists Association

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Measurement of Pharmacist-Physician Collaborative Care on Therapeutic Inertia in Patients With Type 2 Diabetes

Cited by 6 publications

References 9 publications

Efficacy of a pharmacist-managed diabetes clinic in high-risk diabetes patients, a randomized controlled trial - “Pharm-MD”

Efficacy of a pharmacist-managed diabetes clinic in high-risk diabetes patients, a randomized controlled trial - “Pharm-MD”

Improving Patient Access to Primary Care Providers Using a Pharmacist-Physician Co-Visit Model

Factors influencing primary care organization commitment to technical assistance for pharmacist clinical services integration

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