Pharmacists improve diabetes outcomes: a randomized controlled trial

Area of Science:

• Health Services Research
• Clinical Pharmacy
• Diabetes Management

Background:

• Growing shortage of primary care physicians necessitates innovative healthcare delivery models.
• Interdisciplinary teams are being explored as part of healthcare reform to address access issues.
• Pharmacists are increasingly recognized for their potential role in expanding healthcare services.

Purpose of the Study:

• To evaluate the impact of integrating a pharmacist into an interprofessional health team on diabetes outcomes.
• To determine if pharmacist involvement improves glycemic control (HbA1c) in diabetic patients.
• To assess secondary outcomes including medication therapy problems, preventive care adherence, and patient satisfaction.

Main Methods:

• A 2-phase pilot study involving Medicaid-eligible patients with diabetes.
• Randomization to either standard care (control) or standard care plus pharmacist care (intervention).
• Primary outcome: change in glycated hemoglobin (A1c); Secondary outcomes: medication therapy problems, preventive care adherence, healthcare utilization, and patient satisfaction.

Main Results:

• Intervention group showed a significantly greater reduction in A1c compared to the control group (0.91 pp difference, P=0.0218).
• Pharmacists identified 2638 medication therapy problems and improved adherence to preventive care visits (nutrition, ophthalmology, dentistry).
• Patient satisfaction was markedly higher in the intervention group, with 78% rating their experience as excellent versus 37% in the control group.

Conclusions:

• Pharmacist comanagement of diabetes patients leads to significant improvements in glucose control and patient satisfaction.
• Integrating pharmacists into interprofessional teams is an effective strategy to enhance diabetes care.
• This model demonstrates the value of pharmacists in addressing healthcare needs and improving patient outcomes.