The Impact of Clinical Pharmacist Integration on a Collaborative Interdisciplinary Diabetes Management Team

Abstract

Objective:

The national initiative, Project IMProving America’s Communities Together (IMPACT): Diabetes, was intended to scale a proven American Pharmacists Association (APhA) Foundation process model, which integrates pharmacists on the collaborative health-care team, in communities greatly affected by diabetes to improve key indicators of diabetes. This article discusses the results from 1 community in Mississippi.

Methods:

This national prospective study followed patients with a hemoglobin A_1c (HbA_1c) >7% from September 2011 to January 2013. Pharmacists collaborated with providers and other health-care professionals to provide medication therapy management services for a minimum of 3 visits. Outcome measures included HbA_1c, systolic and diastolic blood pressure (SBP and DBP), fasting cholesterol panel, body mass index (BMI), influenza vaccine and smoking status, and foot and eye examination dates.

Results:

At this site, there were statistically significant outcomes including mean HbA_1c decrease of 1.2% in SBP and DBP of 8.3 mm Hg and 3.5 mm Hg, respectively, and reduction in low-density lipoprotein of 16.6 mg/dL, all of which were greater improvements compared to overall results from combined sites.

Conclusion:

Patients in this community who received care from the collaborative team, including a pharmacist, had improvement in most key indicators of diabetes, with a clinically significant reduction in HbA_1c.

Keywords

ambulatory care endocrinology

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References

Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2014.

Mississippi State Department of Health. Diabetes in Mississippi. Web site. http://msdh.ms.gov/msdhsite/_static/43,0,296.html. Updated September 6, 2012. Accessed January 17, 2014.

Diabetes Foundation of Mississippi, INC. Statistics and Burden of Diabetes on Mississippi: The Burden of Diabetes on Mississippi. Ridgeland, MS: Diabetes Foundation of Mississippi, INC. Web site. https://www.msdiabetes.org/statistics-and-burden-diabetes-mississippi. Updated 2014. Accessed April 27, 2015.

Cranor

Christensen

. The Asheville Project: short-term outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43(2):149–159.

Fera

Bluml

Ellis

. Diabetes ten city challenge: final economic and clinical results. J Am Pharm Assoc. 2013;49(3):383–391.

Collier

Baker

. Implementation of a pharmacist-supervised outpatient diabetes treatment clinic. Am J Health Syst Pharm. 2014;71(1):27–36.

Shah

. Enhancing diabetes care by adding a pharmacist to the primary care team. Am J Health Syst Pharm. 2013;70(10):877–886.

Berdine

Skomo

. Development and integration of pharmacist clinical services into the patient-centered medical home. J Am Pharm Assoc. 2012;52(5):661–667.

Pepper

Mallory

Coker

. Pharmacists’ impact on improving outcomes in patients with type 2 diabetes mellitus. Diabetes Educ. 2012;38(3):409–416.

10.

Bluml

Watson

Skelton

. Improving outcomes for diverse populations disproportionately affected by diabetes: final results of Project IMPACT: Diabetes. J Am Pharm Assoc (2003). 2014;54(5):477–485.

11.

Garrett

Bluml

. Patient Self-management program for diabetes: first-year clinical, humanistic, and economic outcomes. J Am Pharm Assoc (2003). 2005;45(2):130–137.

12.

Chobanian

Bakris

Black

; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The seventh report of the national committee on prevention, detection, evaluation, and treatment of high blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–2572.

13.

American Diabetes Association. Standards of medical care in diabetes-2012. Diabetes Care. 2012;35(suppl 1):s11–s63.

14.

American Diabetes Association. Standards of medical care in diabetes-2016. Diabetes Care.2016;39(suppl 1):s60–s71.

15.

James

Oparil

Carter

. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the eighth joint national committee (JNC 8). JAMA. 2014;311(5):507–520.

16.

Centers for Disease Control and Prevention. Adult Obesity Facts. Atlanta, GA: Centers for Disease Control and Prevention. Web site. http://www.cdc.gov/obesity/data/adult.html. Updated September 21, 2015. Accessed January 27, 2014.