药剂师领导的持续葡萄糖监测试点诊所的临床和财务成果。

Innovations in pharmacy Pub Date : 2024-03-18 eCollection Date: 2024-01-01 DOI:10.24926/iip.v15i1.6081
Leigh Ballard, Adriane L York, Jessica W Skelley, Marion Sims
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摘要

目的: 作为联邦合格医疗中心(FQHC)药剂师主导的试点服务的一部分,使用连续血糖监测仪(CGM)的患者的临床和财务结果如何?方法:这项于 2022 年 10 月至 2023 年 9 月在一家 FQHC 进行的单中心前瞻性队列研究已提交给 IRB 审查[EXMT-P-22-F-17]。药剂师与主治医师合作,在糖尿病专科门诊中对患者进行诊治。由药剂师主导的门诊共接诊了 15 名患者(5 名男性和 10 名女性)。每 3 个月安排一次面诊随访,以检测血红蛋白 A1c(HbA1c),患者也可以到诊所进行额外的就诊。对报销率进行了分析,以确定药房服务的经济效益。结果药剂师为 15 名患者进行了首次 CGM 检查,其中 8 名患者进行了复查。首次就诊时的平均 HbA1c 为 10% ± 2.49,最后一次随访时降至 8.05% ± 0.29。8 名患者通过 CGM 设备或在线数据监测获得了在量程范围内的时间(TIR)。首次药剂师访问后 2 周的平均 TIR 为 39.625% ± 23.19,项目结束时增至 48.75% ± 11.41。共进行了 39 次访问,报销总额为 5,978.54 美元。结论:这个由药剂师主导的 CGM 试点诊所改善了临床疗效,除了典型的门诊收入外,还为糖尿病管理提供了经济补偿。进一步的研究应侧重于药剂师主导的连续血糖监测门诊对更大患者群体的临床影响,以及医生诊所和 FQHC 服务在财务上的可持续性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and Financial Outcomes of a Pilot Pharmacist-Led Continuous Glucose Monitoring Clinic.

Purpose: What are the clinical and financial outcomes of patients using a continuous glucose monitor (CGM) as part of a pilot pharmacist-led service in a Federally Qualified Health Center (FQHC)? Methods: This single-center, prospective cohort conducted in a FQHC from October 2022 to September 2023 was submitted to IRB for review [EXMT-P-22-F-17]. Patients were seen by a pharmacist in collaboration with an attending physician during diabetes specific visits. A total of 15 patients were seen in the pharmacist-led clinic (5 males and 10 females). While follow-up visits were scheduled in-person every 3 months to obtain a hemoglobin A1c (HbA1c), patients could also be seen in the clinic for additional visits. Reimbursement rates were analyzed to determine financial outcomes of the pharmacy service. Results: Pharmacists saw 15 patients for their initial CGM visits, with 8 patients returning for follow-up. The average HbA1c at the first visit was 10% ± 2.49 and decreased at the last follow-up to 8.05% ± 0.29. Time in range (TIR) was obtained for 8 patients through the CGM device or online data monitoring. The average TIR 2 weeks after the first pharmacist visit was 39.625% ± 23.19 and increased to 48.75% ± 11.41 at the completion of the project. A total of 39 visits were conducted, with a total reimbursement rate of $5,978.54. Conclusion: This pharmacist-led pilot CGM clinic showed improvements in clinical outcomes and provided financial reimbursement for diabetes management in addition to typical office visit revenue. Further research should focus on clinical impact of pharmacist-led continuous glucose monitor clinics in larger patient populations, as well as financial sustainability of the service in both physician clinics and FQHC's.

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