Evaluation of pharmacist consults within a collaborative enhanced primary care team model to improve diabetes care

Abstract

Background An enhanced primary care team model was implemented to provide proactive, longitudinal care to patients with diabetes, grounded in close partnership between primary care providers (PCPs), nurses, and Medication Management Services (MMS) pharmacists. The purpose of this study is to evaluate the impact of the MMS pharmacist involvement in the enhanced primary care model for patients with diabetes. Methods This retrospective cohort study compared the quality of diabetes care between patients referred to a pharmacist and propensity score matched controls who were not. Eligible patients were adults (age 18 to 75 years) enrolled in the enhanced primary care team process who did not meet at least one of four diabetes quality indicators at 13 Mayo Clinic Rochester primary care practice locations. The intervention examined was asynchronous e-consults by pharmacists affiliated with the primary care practice. Main measures The primary outcome was change in the proportion of patients meeting the composite of four diabetes treatment goals (D4), including hemoglobin A1c (HbA1c) control, blood pressure control, aspirin use, and statin use at six months from enrollment among patients who received pharmacist intervention compared to matched patients who did not. Secondary outcomes were each of the D4 goal individually. Results The proportion of patients meeting the D4 increased with pharmacist e-consults (N = 85) compared to matched controls with no review (N = 170) (27% vs 7.0%, p<0.001). The change in patients meeting treatment goals of HbA1c (12.9% vs 4.1%, p = 0.020), blood pressure (9.4% vs 2.4%, p = 0.023), aspirin use (10.6% vs 2.9%, p = 0.018), and statin use (17.6% vs -1.2%, p<0.001) all increased with pharmacist e-consults. Conclusions Pharmacist engagement in the enhanced primary care team improved diabetes management. This supports the inclusion and utilization of pharmacists in multidisciplinary efforts to improve diabetes care.

Development and Implementation of Workshops to Optimize the Delivery of Vaccination Services in Community Pharmacies: Thinking beyond COVID-19

“…Due to the overall success of these workshops, our future objectives also involve collaborating with pharmacists in Canada and elsewhere to explore other emerging topics beyond vaccinations. These include enhancing community pharmacist-led interventions for patients with diabetes [ 48 ], optimizing patients’ prescription programs through deprescribing [ 49 ], and pharmacist involvement in the screening and management of asthma care and chronic respiratory diseases [ 50 , 51 ]. In conclusion, as the roles of pharmacists and community pharmacies continue to evolve in Canada and across the globe, ensuring successful patient-centered care necessitates enhancing pharmacists’ knowledge, skills, and performance.…”

Type 2 Diabetes Patients’ Views of Local Pharmacists and Fulfilment with Pharmaceutical Diabetes Care in Syria’s Latakia Governorate: An Online Survey Research

“…Although the use of medications helps to manage the HbA1c goal, a unique multidisciplinary team approach is also needed. Enhancing the effectiveness and efficiency of diabetic care requires the support of doctors, pharmacists, and nurses [ 17 , 18 ]. On average, a person with diabetes is estimated to visit the pharmacy three to eight times more frequently than other patients [ 19 ].…”