Comparing Clinical Outcomes of a Pharmacist-Managed Diabetes Clinic to Usual Physician-Based Care

Jordan L Schultz; Kathleen E Horner; Deanna L McDanel; Michelle L Miller; Randi L Beranek; Ryan B Jacobsen; Nichole J Sly; Aaron C Miller; Lisa A Mascardo

doi:10.1177/0897190017710522

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Comparing Clinical Outcomes of a Pharmacist-Managed Diabetes Clinic to Usual Physician-Based Care

Journal article

Peer reviewed

Comparing Clinical Outcomes of a Pharmacist-Managed Diabetes Clinic to Usual Physician-Based Care

Jordan L Schultz, Kathleen E Horner, Deanna L McDanel, Michelle L Miller, Randi L Beranek, Ryan B Jacobsen, Nichole J Sly, Aaron C Miller and Lisa A Mascardo

Journal of pharmacy practice, Vol.31(3), pp.268-271

06/2018

DOI: 10.1177/0897190017710522

PMID: 28532224

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Abstract

This study analyzed the impact of a pharmacist-managed diabetes clinic on clinical outcomes compared to usual care received from primary care providers (PCPs). This comparison may more definitively demonstrate the value of pharmacist management of chronic disease states. Retrospective observational cohort study conducted in patients referred to a pharmacist-managed pharmacotherapy (PT) clinic from July 2009 to October 2014. For the primary outcome, the absolute change in A1c during the usual care phase was +1.53% (95% confidence interval [CI]: 1.10-1.96, P < .0001) versus an absolute change of -1.63% (95% CI: -1.28 to -1.97, P < .0001) in the intervention phase. For secondary outcomes, diabetes-related hospitalizations (10 vs 6, P = .104) and emergency room (ER) visits (27 vs 8, P = .049) decreased in the intervention phase compared to the usual care phase. The rate of diabetes-related interventions made per patient per year in the usual care phase was 2.7 versus 11.1 in the intervention phase ( P < .0001). Patients referred to the PT clinic had worsening blood glucose control prior to referral, and their control improved after referral to the clinic. Furthermore, there was an improvement in all diabetes-related outcomes in the intervention phase compared to the usual care phase.

Patient Care - trends

Humans

Middle Aged

Pharmacists - standards

Ambulatory Care Facilities - trends

Male

Treatment Outcome

Patient Care - standards

Professional Role

Pharmacists - trends

Referral and Consultation - standards

Diabetes Mellitus, Type 2 - blood

Patient Care - methods

Physicians - standards

Diabetes Mellitus, Type 2 - therapy

Aged, 80 and over

Physicians - trends

Adult

Female

Aged

Ambulatory Care Facilities - standards

Referral and Consultation - trends

Retrospective Studies

Cohort Studies

Details

Title: Subtitle: Comparing Clinical Outcomes of a Pharmacist-Managed Diabetes Clinic to Usual Physician-Based Care
Creators: Jordan L Schultz - 2 Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Kathleen E Horner - 1 Department of Pharmaceutical Care, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Deanna L McDanel - 3 The University of Iowa College of Pharmacy, Iowa City, IA, USA
Michelle L Miller - 1 Department of Pharmaceutical Care, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Randi L Beranek - 1 Department of Pharmaceutical Care, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Ryan B Jacobsen - 2 Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Nichole J Sly - 4 Department of Pharmacy, Froedtert Hospital, Milwaukee, WI, USA
Aaron C Miller - 5 Department of Business and Economics, Cornell College, Mount Vernon, IA, USA
Lisa A Mascardo - 1 Department of Pharmaceutical Care, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Journal of pharmacy practice, Vol.31(3), pp.268-271
DOI: 10.1177/0897190017710522
PMID: 28532224
NLM abbreviation: J Pharm Pract
ISSN: 0897-1900
eISSN: 1531-1937
Publisher: United States
Language: English
Date published: 06/2018
Academic Unit: Neurology; Psychiatry; Epidemiology; Psychological and Brain Sciences; Iowa Neuroscience Institute; Pharmacy Practice and Science; Internal Medicine
Record Identifier: 9984004075102771

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