Impact of professional continuous glucose monitoring by clinical pharmacists in an ambulatory care setting

Abstract

IntroductionUse of continuous glucose monitoring (CGM) in the management of diabetes continues to grow. Despite professional‐use CGM serving as an opportunity for clinical pharmacists to improve care and generate revenue for managing patients with diabetes, there is limited literature describing their involvement with this technology.ObjectivesThe primary objective was to determine if professional CGM improves measures of glycemic control including percentage of time in target glycemic range, change in estimated average interstitial glucose, and change in hemoglobin A1c (HbA1c) from baseline to postintervention. Secondary objectives were to evaluate revenue generation measured by reimbursement rates for Current Procedural Terminology (CPT) codes 95250 and 95251 and utilization of clinical pharmacist services related to professional CGM.MethodsThis was a quasi‐experimental, retrospective, pre‐post intervention analysis. Patients that had a professional CGM placed and more than 24 hours of data interpreted by a clinical pharmacist were included for analysis. All clinical data were extracted from patients' electronic medical records, while reimbursement data were provided by the organization's billing department.ResultsTwenty‐nine patients that received professional CGM were included for analysis. Patients' mean baseline and post‐intervention HbA1c were 9.0% and 8.3%, respectively (P = 0.156). There was no difference in the mean percentage of time in target glycemic range (P = 0.966) or mean estimated average interstitial glucose (P = 0.779) from baseline to post‐intervention. Patients met with clinical pharmacists for a total of 68 follow‐up visits during their individual 14‐day wear periods, 14 of which were unanticipated visits. The mean payment amount for CPT code 95250 was $126.87, while $39.17 was received for 95251.ConclusionsClinical pharmacist‐led professional CGM did not demonstrate a statistically significant difference in measures of glycemic control; however, the 14‐day device wear period provided opportunities for optimization of antihyperglycemic therapy that resulted in a clinically significant reduction in HbA1c and reimbursement for clinical pharmacy services.