Evaluation of a Pharmacist-Led Diabetes Collaborative Drug Therapy Management Service

Abstract

Objective: To evaluate the pharmacist-led diabetes collaborative drug therapy management services in a family medicine and internal medicine clinic. Design: Mixed methods of evaluation based on the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Results: Reach: 71.3% of patients who were independently consulted (n = 184/258) and 1.6% (n = 11/680) of patients who triggered a best practice advisory (BPA) were enrolled. Effectiveness: 27.7% of patients (n = 54/195) enrolled were lost to follow-up. Adoption: 55% of eligible providers (n = 77/140) have placed a consult. Implementation: Providers independently choose to refer patients and are also prompted to place consults by a BPA that triggers for patients with an HbA1c ≥ 9%. Common reasons providers did not place a consult include: alignment with workflow, patient refusal, and patients followed by other services. Regarding patient perceptions, patients valued the service. Patients reported increased accountability with disease state maintenance and increased self-efficacy. Regarding how to improve the service, patients wanted more information on expectations before engaging with the pharmacist. Patients suggested to replicate this service for pain, cancer, and blood pressure management. Maintenance: 96.7% of providers (n = 30/31) reported they were very likely/likely to place a consult in the future and 60% of providers (n = 18/30) reported they were very likely/likely to place a consult when prompted by the BPA. Conclusion: These results can be utilized to make improvements to the pharmacist-led diabetes collaborative drug therapy management service to ensure sustainability. This study also provides lessons learned and strategies for future adoption, implementation, and maintenance of similar services for other disease states.