![[ Visit Client Website ]](images/banner.gif)
Purpose: This study assessed the impact of a statewide pharmacist-physician collaborative practice model to care for patients with type 2 diabetes mellitus (DM2) on disease-oriented endpoints.
Methods: This was a prospective, quasi-experimental before and after study that enrolled patients from seven different primary care practice sites in Tennessee. Eligible patients were ≥ 18 years of age, diagnosed with DM2 with a life expectancy greater than 12 months and had either a glycosylated hemoglobin (A1c) >7%, or blood pressure above 130/80mmHg, or low density lipoprotein (LDL) greater than 100 mg/dL. Care was provided to patients in a collaborative manner with involvement from both clinical pharmacists and physicians. Patients were followed prospectively for 12 months. Primary outcomes evaluated included: A1c, percentage of patients with A1c <7%, and percentage of patients with A1c >9%. Paired t-tests were used to assess continuous data and McNemar’s test was used for categorical data. A p-value <0.05 was considered significant.
Results: A total of 206 patients were enrolled in the study. At baseline, mean A1c was 8.90±1.97%. A significant difference was observed in post-intervention A1c (mean 7.74±1.69%; p<0.0001). Patients achieving A1c <7% significantly increased following the intervention (pre-intervention 12.75% vs. post-intervention 36.76%; p=0.0002). Patients with A1c >9% significantly decreased (pre-intervention 34.15% vs. post-intervention 16.50%; p<0.0001). Total number of anti-hyperglycemia drugs remained stable (mean 1.78±0.92 pre-intervention vs. 1.72±0.85 post-intervention; p=0.9909).
Conclusion: Implementation of a collaborative practice model between pharmacists and physicians improved DM2-related disease endpoints without increasing the total number of anti-hyperglycemic agents. This study adds to the existing literature supporting pharmacist involvement in the management of diabetes as very few multi-center, prospective studies have been reported.