Related Experiment Video
Updated: May 22, 2025
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
18.5K
Pharmacist Integration to Support Continuous Glucose Monitoring Initiation: A Collaborative, Patient-Centered
James Thurston1, Hanlin Li1, Mangala Rajan2
1Department of Pharmacy, New York-Presbyterian Hospital, New York, NY, USA.
Journal of Pharmacy Practice
|March 14, 2025
Summary
Clinical pharmacists significantly improve glycemic control in diabetes patients by assisting with continuous glucose monitoring (CGM) initiation. Pharmacist support, especially under collaborative drug therapy management, leads to substantial A1c reductions.
Area of Science:
- Endocrinology
- Pharmacology
- Diabetes Management
Background:
- Continuous glucose monitoring (CGM) improves glycemic control in diabetes.
- Clinical pharmacists can enhance CGM adoption through education and support.
- Limited evidence exists on the effectiveness of pharmacist-assisted CGM initiation.
Purpose of the Study:
- To evaluate the impact of clinical pharmacist-assisted CGM implementation on glycemic control.
- To assess changes in A1c levels following pharmacist-supported CGM initiation.
Main Methods:
- Retrospective pre-post study design.
- Analysis of A1c changes in patients receiving pharmacist assistance for CGM initiation (Jan 2019-Dec 2023).
- Comparison of A1c changes between patients under collaborative drug therapy management (CDTM) and those not.
Main Results:
- Pharmacist-assisted CGM initiation resulted in a significant mean A1c decrease of -0.71 (P < 0.001).
- The CDTM subgroup showed a greater mean A1c reduction of -1.60 (P = 0.002).
- The non-CDTM subgroup achieved a mean A1c reduction of -0.50 (P < 0.001).
Conclusions:
- Clinical pharmacists effectively reduce A1c levels in diabetes patients through CGM support.
- Pharmacist-led CGM initiation, education, and follow-up are beneficial.
- Patients managed under CDTM agreements by pharmacists experienced the most significant A1c improvements.
Related Concept Videos
01:14SBAR II: Application of SBAR
4.3K
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
4.3K
01:30Pulse rhythm
749
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
749
01:15Diabetes: Management and Pharmacotherapy
220
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
220
01:15Hypoglycemia and Glucagon
146
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
146
01:06Oral Hypoglycemic Agents: Glinides
124
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
124
01:24Glucagon-like Receptor Agonists
281
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
281