Continuous glucose monitor outcomes in Latino populations across multiple federally qualified health centers

IF 1.3 Q4 PHARMACOLOGY & PHARMACY

Journal of the American College of Clinical Pharmacy : JACCP Pub Date : 2025-02-11 DOI:10.1002/jac5.70007

Ana Hernandez-Calderon Pharm.D., Jasmine Gonzalvo Pharm.D., Jessica S. Triboletti Pharm.D., Todd A. Walroth Pharm.D., Samuel P. Lewis Pharm.D., M.S., Lauren Pence Pharm.D.

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Abstract

Background

Utilization of continuous glucose monitoring (CGM) leads to a greater reduction in hemoglobin A1C (A1C) in individuals with diabetes compared with fingerstick blood glucose monitoring (BGM) alone. CGM also reduces diabetes-related hospitalizations. Evidence shows CGM is underutilized in racial or ethnic minority groups.

Objectives

There is a need to increase CGM access and evaluate the impact in underrepresented populations to prevent health disparities. Eskenazi Health added CGM devices as a covered product on the Eskenazi Health Financial Assistance Program (EH FAP) formulary. CGMs were approved for patients with diabetes taking insulin or a sulfonylurea. The purpose of this study was to assess the clinical impact of improving CGM access following EH FAP coverage with a focus on Latino populations across multiple Federally Qualified Health Centers (FQHCs).

Methods

A retrospective, cohort study of nine FQHCs was conducted for all adults with EH FAP who were dispensed CGMs at Eskenazi Health outpatient pharmacies between June 1, 2022 and December 31, 2023. The primary outcome was A1C pre- and post-CGM use. Secondary outcomes included CGM adherence as characterized by proportion of days covered (PDC). All outcomes were also assessed in predetermined subgroups comparing Pharm.D. versus Primary Care and Endocrinology providers and Latino versus non-Latino individuals.

Results

A total of 184 individuals were included. Median (interquartile range) A1C at baseline was 9.6% (8.1, 11.8). At 3 months, median A1C decreased to 8.4% (n = 96; change of −0.9%; p < 0.001); at 1 month, median A1C decreased to 7.9% (n = 19; change of −1.1%; p = 0.028); and at 6 months, median A1C decreased to 8.4% (n = 55; change of −0.7; p = 0.007). PDC resulted as a median of 100% (77, 100). No difference in A1C outcomes were observed between Pharm.D. versus other prescribers.