Clinical and Financial Outcomes of a Pilot Pharmacist-Led Continuous Glucose Monitoring Clinic.

Abstract

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.