Christina Mnatzaganian, Mark Bounthavong, Wendelle Abalos, Truc Chau, Oluchi Nwosu, Andrew Yi, Ila Saunders, Panteha Kelly
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Abstract
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 2 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 3 months (P < 0.001) and 1.74% at 6 months (P < 0.001) after initial visit. Time in range improved by 8.2% at 3 months (P < 0.001) and by 12.1% at 6 months (P < 0.001). The glucose management indicator decreased by 0.27% at 3 months (P < 0.001) and 0.53% at 6 months (P < 0.001). The average glucose decreased by 13.5 mg/dL at 3 months (P < 0.001) and 18.8 mg/dL at 6 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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