Pharmacist Integration to Support Continuous Glucose Monitoring Initiation: A Collaborative, Patient-Centered Approach.

Abstract

Objective: The development of continuous glucose monitoring (CGM) has allowed for improved glycemic control among patients with diabetes. Clinical pharmacists possess medication expertise and can provide support for increased CGM utilization through device education and affordability assistance, but there is limited evidence evaluating the effectiveness of clinical pharmacist-assisted CGM initiation. The objective of this study was to examine how clinical pharmacist-assisted CGM implementation can impact glycemic control for patients with diabetes. Methods: This is a retrospective pre-post study that evaluated change in A1c among patients who were assisted with CGM device implementation by a clinical pharmacist between January 1, 2019, and December 31, 2023. The primary outcome of this study was change in A1c from baseline (prior to CGM initiation) to the next subsequent A1c following CGM initiation. The study team also investigated change in A1c among a subgroup of patients followed independently by clinical pharmacists practicing under a collaborative drug therapy management (CDTM) agreement. Results: Pharmacist-assisted CGM initiation led to a statically significant decrease in mean A1c of -0.71 (CI 95% 0.41-1.00, P < 0.001) across all patients. Within the CDTM subgroup, the mean A1c difference was -1.60 (CI 95% 0.64-2.55, P = 0.002) while in the non-CDTM subgroup, the mean A1c difference was -0.50 (CI 95% 0.22-0.78, P < 0.001). Conclusions: Clinical pharmacists are effective at helping patients with diabetes reduce their A1c through assisting with CGM initiation, education, and follow-up. Among patients included in this study, those followed by pharmacists practicing under CDTM agreements saw the greatest amount of A1c reduction.