Impact of an Advanced Practice Pharmacist Type 2 Diabetes Management Program: A Pilot Study

Area of Science:

• Endocrinology
• Pharmacology
• Healthcare Management

Background:

• Type 2 diabetes mellitus (T2DM) management requires continuous monitoring and intervention.
• Patient-centered medical homes (PCMH) aim to improve chronic disease care coordination.
• The role of Advanced Practice Pharmacists (APh) in T2DM management within PCMH settings is an area of growing interest.

Purpose of the Study:

• To evaluate the impact of an Advanced Practice Pharmacist (APh) on reducing hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes.
• To characterize the specific therapeutic decisions made by an APh during diabetes management within a PCMH.
• To assess the effectiveness of pharmacist-led interventions in a collaborative practice model.

Main Methods:

• Retrospective study utilizing electronic health records from a partnership between Chapman University School of Pharmacy and Providence St. Joseph Heritage Healthcare.
• Analysis of HbA1c changes as the primary endpoint in patients managed by an APh under a collaborative practice agreement.
• Descriptive analysis and Wilcoxon signed rank test were employed for data analysis.

Main Results:

• The study included 35 patients with type 2 diabetes managed by an APh between May 2017 and December 2017.
• Average HbA1c decreased significantly from 8.8%±1.4% to 7.5%±1.4% (p<0.0001).
• Common APh therapeutic decisions included drug dose increases (35.5%), adding new medications (16.4%), and dose decreases (6.4%).

Conclusions:

• APh interventions demonstrated a significant positive effect on lowering HbA1c in T2DM patients within a PCMH.
• Pharmacist-led medication management, including dose adjustments and new drug additions, effectively improved glycemic control.
• This study highlights the value of APhs in enhancing diabetes care within integrated healthcare settings.