Outcomes from DiabetesCARE: a pharmacist-provided diabetes management service.
OBJECTIVE
To describe outcomes attained by the DiabetesCARE component of the PharmacistCARE program, which is an innovative pharmacy practice model implemented within a self-insured employer.


METHODS
Descriptive nonexperimental study.


METHODS
University of Kentucky (UK), from March 2003 through December 2006.


METHODS
236 patients with diabetes (95% with type 2 diabetes).


METHODS
Three clinical pharmacists provided UK Health Plan (UKHP) members with diabetes with comprehensive disease state and medication therapy management.


METHODS
Clinical outcomes included glycosylated hemoglobin (A1C), fasting lipid panels, blood pressure, weight, vaccination rates, and aspirin use. Humanistic outcomes included the mental and physical components of the 12-Item Short-Form Health Survey (SF-12) and patient satisfaction with health services related to their diabetes care. Screening parameters included the proportion of patients meeting Healthcare Effectiveness Data and Information Set expectations for patients with diabetes. Productivity and health resource use were also assessed based on patient responses to survey questions.


RESULTS
After 1 year of enrollment, patients in the DiabetesCARE program achieved improved clinical outcomes compared with baseline, as evidenced by statistically significant reductions in A1C, low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Statistically significant increases were seen in high-density lipoprotein cholesterol and the proportion of patients obtaining influenza vaccine, yearly screenings for lipid level assessment, screenings for kidney disease, and eye examinations. The mental component score of the SF-12 was significantly increased. Patients were highly satisfied with the DiabetesCARE service, and satisfaction with their overall diabetes care within UKHP was significantly enhanced. Based on the patient provided survey data analyzed here, productivity and health resource use were unchanged; however, additional analyses using UKHP claims data are ongoing.


CONCLUSIONS
The DiabetesCARE program is a unique pharmacist-provided service delivered in a freestanding pharmacist clinic that enhances health outcomes for adult members with diabetes in a self-insured employer group.
Johnson
Carrie L
CL
College of Pharmacy, University of Kentucky, Lexington, KY 40536-0082, USA.
Nicholas
Amy
A
Divine
Holly
H
Perrier
Donald G
DG
Blumenschein
Karen
K
Steinke
Douglas T
DT
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration; D048909:Diabetes Complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006306:Health Surveys; D006801:Humans; D007629:Kentucky; D008055:Lipids / Q000097:blood; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D017060:Patient Satisfaction; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; D008055:Lipids