1289-P: The Impact of Medication Interventions in a Clinical Pharmacy Specialist Medication Management Clinic on A1C Reduction and Glycemic Goals

Abstract

Background: To identify the effects of medication interventions made in diabetic patients in a clinical pharmacy specialist (CPS) medication management clinic on A1C reduction and achievement of glycemic goals in a Department of Veterans Affairs (VA) clinic setting. Methods: A total of 61 new patients referred to the CPS medication management clinic between October 1, 2017, and March 31, 2018, were evaluated. The number of medication interventions at the initial CPS visit, and all visits in the first 6 months of clinic enrollment, were assessed. The patient’s baseline A1C was assessed prior to enrollment in clinic, followed by re-assessment 3 and 6 months later. The number of patient visits during the 6-month period was individualized. Results: A total of 53 patients were included. The average baseline A1C was 9.19% (range of 5.2% to 14%). The average A1C at 3 months was 7.96%, and the average A1C at 6 months was 7.29%. The average change in A1C was -1.3% in 3 months and -2.27% in 6 months. The CPS made a median of 2 medication interventions at the initial visit (range of 0 to 7), including a median of 2 diabetes medication interventions (range of 0 to 5). The CPS made a total of 259 medication interventions during the 6-month period, with a median of 5 medication interventions per patient (range of 1 to 11). The CPS had 243 total patient visits during the 6-month period, with a median of 4 visits per patient (range of 1 to 12). Seventeen patients (32%) had achieved A1C goal at 3 months, and twenty-five patients (47%) had achieved A1C goal at 6 months. Forty-two patients (79%) had achieved appropriate statin use at 3 months. Conclusions: This project demonstrates how the CPS medication management clinic achieved substantial A1C reduction within the first 6 months of patient referral, as well as positive impacts on glycemic goals. The CPS in the VA is uniquely poised to positively impact patient outcomes, and this practice model has potential for future adaptation to other settings. Disclosure L. Desko: None.