Effectiveness of pharmacist-administered diabetes mellitus education and management services.
OBJECTIVE
To evaluate the effectiveness of pharmacist-administered diabetes mellitus education and management services on selected diabetes performance measures. Additional goals were to compare outcomes with goals specified for patients with diabetes by the National Committee for Quality Assurance (NCQA) and identify areas for improvement.


METHODS
One-year observational study.


METHODS
Three university-based primary care clinics.


METHODS
One hundred ninety-one patients with diabetes. Intervention. Pharmacist-provided diabetes education and management services.


RESULTS
Each patient was assessed for hemoglobin A1c (A1C) values, blood pressure, low-density lipoprotein cholesterol (LDL) levels, and aspirin use at baseline and at 1 year after enrollment. Cost avoidance comparators were calculated for those patients with reductions in A1C of at least 1%. Average A1C at 1 year was 7.8% (range 4.5-13.9%) versus 9.5% (range 5.4-19%) at baseline (change -1.7%, p<0.05). Seventy-two patients (38%) experienced a 1% or greater reduction in A1C. Average blood pressure decreased over the study period from 141/79 to 135/75 mm Hg (p=0.007), but average LDL levels did not change to a statistically significant extent (114 to 112 mg/dl, p>0.05). Aspirin use increased from 34% at baseline to 73% at 1 year (p<0.0001). The program achieved the A1C and LDL values required to qualify for NCQA diabetes recognition. Based on an estimated savings of $820 for each 1% decrease in A1C, cost avoidance was calculated as $59,040.


CONCLUSIONS
Diabetes management services from clinical pharmacists achieved significant improvements in A1C values, blood pressure, and aspirin use. Continued efforts in diabetes education and management are needed to further improve clinical, economic, and humanistic outcomes.
Ragucci
Kelly R
KR
Department of Pharmacy and Clinical Sciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA. raguccik@musc.edu
Fermo
Joli D
JD
Wessell
Andrea M
AM
Chumney
Elinor C
EC
D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000458:organization & administration*; D010593:Pharmaceutical Services / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration
D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin