Abstract

Two clinical pharmacy faculty members from a college of pharmacy provide comprehensive medication management in a rural family medicine clinic. The data was assessed for patients with diabetes managed by the pharmacists from 1 January 2017 through to 31 December 2019 to determine the service’s impact on patient outcomes. The primary outcome of this study is the change in the goal attainment rates of the three clinical goals of hemoglobin A1c, blood pressure, and appropriate statin therapy after pharmacist intervention. A total of 207 patients were included. At baseline, the patients had an average of 1.13 of the three goals met, improving to an average of 2.02 goals met after pharmacist intervention (p < 0.001). At baseline, 4.8% of the patients had met all three clinical goals, improving to 30.9% after pharmacist intervention (p < 0.001). There were significant improvements for the individual goal attainment rates of hemoglobin A1c (24.15% vs. 51.21%, p < 0.001), blood pressure (42.51% vs. 85.51%, p < 0.001), and appropriate statin therapy (45.89% vs. 65.70%, p < 0.001). This data adds to the evidence supporting the integration of clinical pharmacists into primary care clinics to improve patient outcomes related to diabetes.

Highlights

  • Ambulatory care pharmacy has been a growing area of the clinical pharmacy profession, where pharmacists work with patients in the outpatient setting to ensure safe and effective medication utilization [1]

  • While there is a plethora of evidence that supports ambulatory care pharmacy in each of these settings, the benefit of a clinical pharmacist integrated into a primary care clinic is well documented [2,3,4,5,6]

  • The goal of this study is to assess the impact that a clinical pharmacist-led comprehensive medication management (CMM) service has on outcomes for patients with diabetes, as evidenced by changes in the goal attainment rates for hemoglobin A1c, blood pressure, and appropriate statin therapy before and after the pharmacist intervention

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Summary

Introduction

Ambulatory care pharmacy has been a growing area of the clinical pharmacy profession, where pharmacists work with patients in the outpatient setting to ensure safe and effective medication utilization [1]. This is becoming a more common area of practice for pharmacists, there has not been a standardization of ambulatory care pharmacy services. There are varying practices, comprehensive medication management (CMM) is becoming a prominent model for pharmacists embedded in primary care clinics [7]. CMM is a model of service provided by clinical pharmacists that ensures each patient’s medication regimen is optimized to ensure the highest safety and efficacy outcomes can be achieved, taking into account patient-specific factors [7]

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