Development of a Continuous Glucose Monitoring Service by Clinical Pharmacists in a Medically Underserved Population.

Innovations in pharmacy Pub Date : 2024-03-18 eCollection Date: 2024-01-01 DOI:10.24926/iip.v15i1.5906
Sara Lingow, Kacie Kinnikin, Justinne Guyton
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Abstract

Background: Continuous glucose monitoring (CGM) is an evolving technology that provides a wealth of information to aid in managing diabetes. Professional CGM (ProCGM) is recommended when personal CGM is not desired or available. Patients in medically underserved areas may have limited access to personal CGM devices, thus ProCGM devices can be used for short-term monitoring and medication adjustment. Clinical pharmacists are well-positioned to help set up and establish personal and professional CGM management services. Objectives: To determine the effect of ProCGM in patients with persistently uncontrolled type 2 diabetes in a medically underserved population (MUP). Methods: Pre-post intervention analysis of a single cohort of patients in a public health center. Patients with persistently uncontrolled (A1c > 9%) and taking at least one daily dose of insulin were included. Included participants wore a ProCGM sensor and met with the clinical pharmacist at least once for ProCGM data interpretation and education. The primary analysis evaluated patients who achieved an A1c <9% 1-6 months after intervention. The change in A1c was also evaluated. Participants completed a pre- and post-survey about their experience. Results: Twenty-two patients were included in the final analysis. Ten patients achieved an A1c <9% (45%). The mean A1c pre- and post-ProCGM was 11.0% and 9.8% respectively, with a decrease of -1.2% (p=0.055) overall and a decrease of -1.7% for patients who wore the sensor for at least 10 days (p=0.012; n=15). Using the CGM data 91% of participants had a change to their medication regimen and 45% achieved an A1c <9%. Six participants experienced hypoglycemia per the CGM report, but only two were aware of it. After reviewing their glucose report with the pharmacist, 95% of the respondents agreed or strongly agreed to feeling more knowledgeable about blood sugar patterns after reviewing the report with a pharmacist. Conclusion: Almost half of the patients in the study achieved an A1c <9%. This study demonstrated glycemic benefit in patients in a MUP who wore a ProCGM for at least 10 days and met with a clinical pharmacist. Data from ProCGM enabled patients to better understand glucose patterns in those with persistently uncontrolled type 2 diabetes.

临床药剂师在医疗服务不足人群中开展持续葡萄糖监测服务。
背景:连续血糖监测(CGM)是一项不断发展的技术,可提供丰富的信息,帮助管理糖尿病。如果不需要或无法使用个人血糖监测仪,建议使用专业血糖监测仪(ProCGM)。医疗服务不足地区的患者可能难以获得个人 CGM 设备,因此 ProCGM 设备可用于短期监测和药物调整。临床药剂师在帮助设置和建立个人及专业 CGM 管理服务方面具有得天独厚的优势。目标:确定 ProCGM 对医疗服务不足人群 (MUP) 中持续未得到控制的 2 型糖尿病患者的效果。方法:对一家公共医疗中心的单组患者进行干预前和干预后分析。纳入的患者均为病情持续失控(A1c > 9%)且每天至少服用一次胰岛素的患者。参与者佩戴 ProCGM 传感器,至少与临床药剂师会面一次,接受 ProCGM 数据解读和教育。主要分析评估了达到 A1c 结果的患者:22 名患者被纳入最终分析。10 名患者的血糖值达到了 A1c:研究中几乎有一半的患者达到了 A1c 指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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