Implementation of a pharmacist-led diabetes management service in an endocrinology clinic. 2022

Rita Parsiani, and Rachael Lundy, and Andrew Ahmann, and Farahnaz Joarder, and Jessica Castle

Diabetes is a complicated health condition that can lead to significant health complications. Pharmacists are in an ideal position to make therapeutic interventions, provide clinical education, and can provide necessary follow-up to evaluate response to therapy for patients with diabetes. The primary objective of this study is to evaluate the mean change in hemoglobin A1c (HbA1c) in patients receiving short-term diabetes management services from a clinical pharmacist through collaborative drug therapy management. This study is a single-center retrospective chart review of patients with diabetes who have been referred by their endocrinologist to the clinical pharmacist for short-term intensification of pharmacologic management of hyperglycemia. Patients included in the study completed at least 2 visits with the pharmacist during the study period. The primary outcome was to evaluate the mean absolute change in HbA1c at 3-6 months from baseline. Data were collected from 117 patients. The average age was 55 years (19-91 years, SD ± 14.5), 65 patients (55.6%) were female, average duration of diabetes was 14.9 years (0.5-49 years, SD ± 9.9), 21 patients (17.9%) had type 1 diabetes, 96 patients (82.1%) had type 2 diabetes, and 88 patients (75.2%) had a baseline HbA1c of at least 8.5%. On average, patients reduced their HbA1c by 2.0% (P < 0.001) at 3-6 months. For patients with a baseline HbA1c of at least 8.5%, they experienced a 2.5% (P < 0.001) reduction in HbA1c at 3-6 months. The addition of a clinical pharmacist within the endocrinology practice was associated with significant improvements in glycemic control for those referred. This short-term, intensive service model demonstrates that patients can achieve significant reductions in HbA1c with temporary support from a clinical pharmacist.

UI MeSH Term Description Entries
D007004 Hypoglycemic Agents Substances which lower blood glucose levels. Antidiabetic,Antidiabetic Agent,Antidiabetic Drug,Antidiabetics,Antihyperglycemic,Antihyperglycemic Agent,Hypoglycemic,Hypoglycemic Agent,Hypoglycemic Drug,Antidiabetic Agents,Antidiabetic Drugs,Antihyperglycemic Agents,Antihyperglycemics,Hypoglycemic Drugs,Hypoglycemic Effect,Hypoglycemic Effects,Hypoglycemics,Agent, Antidiabetic,Agent, Antihyperglycemic,Agent, Hypoglycemic,Agents, Antidiabetic,Agents, Antihyperglycemic,Agents, Hypoglycemic,Drug, Antidiabetic,Drug, Hypoglycemic,Drugs, Antidiabetic,Drugs, Hypoglycemic,Effect, Hypoglycemic,Effects, Hypoglycemic
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010595 Pharmacists Those persons legally qualified by education and training to engage in the practice of pharmacy. Clinical Pharmacists,Community Pharmacists,Retail Pharmacists,Clinical Pharmacist,Community Pharmacist,Pharmacist,Pharmacist, Clinical,Pharmacist, Community,Pharmacist, Retail,Pharmacists, Clinical,Pharmacists, Community,Pharmacists, Retail,Retail Pharmacist
D003924 Diabetes Mellitus, Type 2 A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY. Diabetes Mellitus, Adult-Onset,Diabetes Mellitus, Ketosis-Resistant,Diabetes Mellitus, Maturity-Onset,Diabetes Mellitus, Non-Insulin-Dependent,Diabetes Mellitus, Slow-Onset,Diabetes Mellitus, Stable,MODY,Maturity-Onset Diabetes Mellitus,NIDDM,Diabetes Mellitus, Non Insulin Dependent,Diabetes Mellitus, Noninsulin Dependent,Diabetes Mellitus, Noninsulin-Dependent,Diabetes Mellitus, Type II,Maturity-Onset Diabetes,Noninsulin-Dependent Diabetes Mellitus,Type 2 Diabetes,Type 2 Diabetes Mellitus,Adult-Onset Diabetes Mellitus,Diabetes Mellitus, Adult Onset,Diabetes Mellitus, Ketosis Resistant,Diabetes Mellitus, Maturity Onset,Diabetes Mellitus, Slow Onset,Diabetes, Maturity-Onset,Diabetes, Type 2,Ketosis-Resistant Diabetes Mellitus,Maturity Onset Diabetes,Maturity Onset Diabetes Mellitus,Non-Insulin-Dependent Diabetes Mellitus,Noninsulin Dependent Diabetes Mellitus,Slow-Onset Diabetes Mellitus,Stable Diabetes Mellitus
D005260 Female Females
D006442 Glycated Hemoglobin Products of non-enzymatic reactions between GLUCOSE and HEMOGLOBIN (occurring as a minor fraction of the hemoglobin of ERYTHROCYTES.) It generally refers to glycated HEMOGLOBIN A. Hemoglobin A1c (Hb A1c) is hemoglobin A with GLYCATION on a terminal VALINE of the beta chain. Glycated hemoglobin A is used as an index of the average blood sugar level over a lifetime of erythrocytes. Fructated Hemoglobins,Glycohemoglobin,Glycohemoglobin A,Glycohemoglobins,Glycosylated Hemoglobin A,Hb A1c,HbA1,Hemoglobin A(1),Hemoglobin A, Glycosylated,Glycated Hemoglobin A,Glycated Hemoglobin A1c,Glycated Hemoglobins,Glycosylated Hemoglobin A1c,Hb A1,Hb A1a+b,Hb A1a-1,Hb A1a-2,Hb A1b,Hemoglobin, Glycated A1a-2,Hemoglobin, Glycated A1b,Hemoglobin, Glycosylated,Hemoglobin, Glycosylated A1a-1,Hemoglobin, Glycosylated A1b,A1a-1 Hemoglobin, Glycosylated,A1a-2 Hemoglobin, Glycated,A1b Hemoglobin, Glycated,A1b Hemoglobin, Glycosylated,Glycated A1a-2 Hemoglobin,Glycated A1b Hemoglobin,Glycosylated A1a-1 Hemoglobin,Glycosylated A1b Hemoglobin,Glycosylated Hemoglobin,Hemoglobin A, Glycated,Hemoglobin A1c, Glycated,Hemoglobin A1c, Glycosylated,Hemoglobin, Glycated,Hemoglobin, Glycated A1a 2,Hemoglobin, Glycosylated A1a 1,Hemoglobins, Fructated,Hemoglobins, Glycated
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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