Impact of pharmacist-led continuous glucose monitoring program on reduction in A1c in an FQHC

Background

Type 2 diabetes mellitus (T2DM) is a common disease affecting 37.3 million people in the United States. The use of continuous glucose monitors (CGMs) has been proven to improve patient glycemic outcomes and lower A1c. There is limited data available regarding the evaluation of personal CGMs in a pharmacist-led CGM management program.

Objectives

The primary objective of the study was to evaluate the effects of a pharmacist-led CGM management program in a Federally Qualified Health Center (FQHC). The secondary objective of the study was to assess the A1c reduction over time in a pharmacist-led CGM management program compared to the use of a CGM alone.

Methods

Family Health Services of Darke County is an FQHC in rural Ohio. Clinical pharmacists provide disease state management services for chronic disease states using a collaborative practice agreement (CPA). The CGM management program consists of uploading patient’s personal CGMs, interpreting the data, providing education, and utilizing a CPA to make therapeutic adjustments based on CGM data. A retrospective cohort analysis was performed. Patients with T2DM were included if they had a baseline A1c within 2 months of initiating a CGM, continued use of the CGM for at least 6 months, A1c measured at 3- or 4-month intervals, and at least one pharmacist-led appointment. Data collected included the date of CGM initiation, date of baseline A1c, baseline, and follow-up A1c readings, number of appointments, and number of medication interventions made by the clinical pharmacist.

Results

A significant reduction in A1c was observed in patients who participated in a pharmacist-led CGM management program.

Conclusion

This study demonstrated the impact that pharmacists can have on health outcomes when utilizing a CPA to provide individualized care.