{"title":"Evaluation of a pharmacist-led personal continuous glucose monitor workflow to improve glycemic management in an internal medicine clinic","authors":"","doi":"10.1016/j.japh.2024.102139","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The use of personal continuous glucose monitors (CGMs) in patients with diabetes has increased substantially and is expected to continue to increase as CGMs become more affordable and insurance plans improve coverage. The utilization of CGMs has improved diabetes management and reduced hypoglycemic events.</p></div><div><h3>Objectives</h3><p>To create pharmacist-led personal CGM workflow and evaluate its impact on glycemic management in patients with diabetes.</p></div><div><h3>Practice Description</h3><p>The study took place at an Internal Medicine Clinic. The practice providers include 2 medical doctors, 5 physician assistants, 2 nurse practitioners, and 1 clinical pharmacist.</p></div><div><h3>Practice Innovation</h3><p>To create and implement a sustainable pharmacy led CGM workflow for enhanced CGM use within an internal medicine clinic.</p></div><div><h3>Evaluation Methods</h3><p>This was a prospective, investigator-initiated pilot study conducted at an Atrium Health Internal Medicine clinic over 28 weeks. In this pilot, 42 patients were qualifying candidates with diabetes and personal CGM use. In addition, 30 patients were followed until study completion and included into final analysis.</p></div><div><h3>Results</h3><p>The average baseline A1c was reduced from 8.3% to 7.1% over a 3- to 6-month period. The pharmacist-led CGM workflow revealed a statistically significant reduction in A1c from baseline by an average of 1.2% (95% CI −0.6 to −1.8, <em>P</em> = 0.0006). On average, patients were enrolled for 19.9 weeks and had an average of 5 visits during this time. During the study duration, 100 medications changes were implemented under the existing clinical pharmacist practitioner agreement between the pharmacists and the provider. Overall, 58 Current Procedural Terminology 95251 codes were billed yielding $7052.00 in billed CGM services for the clinic. This project generated 40.6 provider relative value units.</p></div><div><h3>Conclusion</h3><p>The utilization of a pharmacist-led personal CGM workflow can improve diabetes outcomes.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Pharmacists Association","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1544319124001596","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The use of personal continuous glucose monitors (CGMs) in patients with diabetes has increased substantially and is expected to continue to increase as CGMs become more affordable and insurance plans improve coverage. The utilization of CGMs has improved diabetes management and reduced hypoglycemic events.
Objectives
To create pharmacist-led personal CGM workflow and evaluate its impact on glycemic management in patients with diabetes.
Practice Description
The study took place at an Internal Medicine Clinic. The practice providers include 2 medical doctors, 5 physician assistants, 2 nurse practitioners, and 1 clinical pharmacist.
Practice Innovation
To create and implement a sustainable pharmacy led CGM workflow for enhanced CGM use within an internal medicine clinic.
Evaluation Methods
This was a prospective, investigator-initiated pilot study conducted at an Atrium Health Internal Medicine clinic over 28 weeks. In this pilot, 42 patients were qualifying candidates with diabetes and personal CGM use. In addition, 30 patients were followed until study completion and included into final analysis.
Results
The average baseline A1c was reduced from 8.3% to 7.1% over a 3- to 6-month period. The pharmacist-led CGM workflow revealed a statistically significant reduction in A1c from baseline by an average of 1.2% (95% CI −0.6 to −1.8, P = 0.0006). On average, patients were enrolled for 19.9 weeks and had an average of 5 visits during this time. During the study duration, 100 medications changes were implemented under the existing clinical pharmacist practitioner agreement between the pharmacists and the provider. Overall, 58 Current Procedural Terminology 95251 codes were billed yielding $7052.00 in billed CGM services for the clinic. This project generated 40.6 provider relative value units.
Conclusion
The utilization of a pharmacist-led personal CGM workflow can improve diabetes outcomes.
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.