Novel Prescription Delivery Program Impact on Hemoglobin A1c in Diabetes Mellitus

Background: While traditional mail-order pharmacies have overcome some barriers to adherence, there is minimal evidence to indicate whether a novel prescription delivery program (PDP) can impact clinical endpoints in common disease states. The use of integrated pharmacy technicians, a local courier service, and hospital-owned pharmacies contributes to a comprehensive continuum of care. This study’s purpose was to assess the impact of a novel PDP on glycemic control in patients with diabetes mellitus (DM). Objectives: The primary objective of this study was to identify the change in glycated hemoglobin level (HbA1c) of DM patients at enrollment in the PDP to approximately one-year post-enrollment. Secondary objectives were to describe the percentage of patients achieving therapeutic goals, characterize enrolled population, and identify medication classes utilized in the PDP. Methods: This was a retrospective quasi-experimental study to evaluate whether implementation of an internally owned and operated PDP would improve HbA1c control for DM patients throughout primary care and specialty networks. Results: A total of 1223 patients were screened for inclusion. A convenience sample of 100 patients were evaluated. The outcome of change in HbA1c of patients with diabetes improved significantly from baseline at enrollment in a PDP to one-year post-enrollment (pre-PDP 8.2% vs post-PDP 7.4%, P < 0.001). Of the patients included in the study, 30% achieved goal HbA1c pre-enrollment in PDP. One-year post-PDP the percentage of patients who achieved goal HbA1c increased to 48% (P = 0.002), which was statistically significant. Conclusion: Among the studied population, enrollment in the PDP was associated with a significant reduction in HbA1c.