Evaluation of remote pharmacist intervention on type 2 diabetes hemoglobin A1c reduction in an accountable care organization

Abstract

Background

The value of clinical pharmacists for ambulatory internal medicine clinics is well recognized, including their role in hemoglobin A1c (HbA1c) reduction in patients with type 2 diabetes mellitus (T2DM). However, there is a lack of data evaluating the clinical impact of remote, referral-based pharmacy programs.

Methods

This multicenter, cohort, retrospective chart review study analyzed the impact of pharmacist interventions on blood glucose control in patients aged 18 years and older who were diagnosed with T2DM with an HbA1c of 8.5% or greater and referred to the clinical pharmacy team for medication evaluation. Primary care providers may have accepted or rejected pharmacist recommendations. The primary study outcome was the mean change in HbA1c from baseline to follow-up at 2 to 5 months. Secondary outcomes included appropriate use of American Diabetes Association–indicated secondary prevention and any occurrence of glycemia-related events (i.e., T2DM-related emergency room visits or hospitalizations).

Results

At the conclusion of the study, the mean change in HbA1c from baseline to follow-up at 2 to 5 months was −2.7% and −0.6% for the accepted and rejected intervention groups, respectively (t = −2.94, P = 0.0068).

Conclusions

The results of this study suggest that remote pharmacist intervention significantly improves blood glucose control in adults with T2DM.

Keywords:

• Accountable care organization
• diabetes mellitus
• pharmacist intervention

DISCLOSURE STATEMENT

Timothy Reynolds, PharmD, MS, has been a paid research consultant to Pfizer and Sanofi. The remaining authors report no competing interests.