Christina Mnatzaganian, Mark Bounthavong, Wendelle Abalos, Truc Chau, Oluchi Nwosu, Andrew Yi, Ila Saunders, Panteha Kelly
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Evaluation of pharmacist-led management of type 2 diabetes using personal continuous glucose monitors across a large tertiary academic health system.
Background: There is limited but positive evidence of the impact of pharmacists in managing patients with type 2 diabetes (T2D) using a personal continuous glucose monitor (CGM). Previous studies have been limited to single clinic pilots or community pharmacies with small sample sizes.
Objectives: To evaluate the impact on glycemic outcomes of an innovative pharmacist-led Diabetes Management and Education Clinic (DMEC) on patients with T2D using a personal CGM.
Practice description: The DMEC operates in primary care settings in a large, tertiary academic health care system serving a large patient population. Pharmacists manage care for patients with T2D who are referred by primary care and specialty medical providers under a collaborative practice agreement.
Practice innovation: To use CGM data to guide decision making for clinical pharmacists seeing patients with T2D in the DMEC.
Evaluation methods: This was a retrospective study conducted at the DMEC over two years. Demographics and glycemic outcomes were collected from the electronic medical record for patients who had a personal CGM prior to the initial clinic visit, supplied during the visit, or ordered as a prescription. A descriptive analysis was completed for this study.
Results: DMEC pharmacists used CGMs to guide treatment decisions for 165 patients. The average hemoglobin A1c decreased by 1.48% at three months (p<0.001) and 1.74% at six months (p<0.001) after initial visit. Time in range improved by 8.2% at three months (p<0.001) and 12.1% at six months (p <0.001). The glucose management indicator decreased by 0.27% at three months (p<0.001) and 0.53% at six months (p<0.001). The average glucose decreased by 13.5 mg/dL at three months (p<0.001) and 18.8 mg/dL at six months (p<0.001).
Conclusion: Pharmacist-led management of T2D using personal CGMs can improve diabetes outcomes in a large academic health care system.
期刊介绍：
The Journal of the American Pharmacists Association is the official peer-reviewed journal of the American Pharmacists Association (APhA), providing information on pharmaceutical care, drug therapy, diseases and other health issues, trends in pharmacy practice and therapeutics, informed opinion, and original research. JAPhA publishes original research, reviews, experiences, and opinion articles that link science to contemporary pharmacy practice to improve patient care.
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