Pharmacist-led group medical appointment model in type 2 diabetes.
The purpose of this study was to assess whether the VA-MEDIC (Veterans Affairs Multi-disciplinary Education and Diabetes Intervention for Cardiac risk reduction), a pharmacist-led group medical visit program, could improve achievement of target goals in hypertension, hyperglycemia, hyperlipidemia, and tobacco use in patients with type 2 diabetes compared to usual care.



This was a randomized controlled trial of VA-MEDIC intervention in addition to usual care versus usual care alone in diabetic patients to reduce cardiac risk factors. VA-MEDIC consisted of a 40- to 60-minute educational component by nurse, nutritionist, physical therapist, or pharmacist followed by pharmacist-led behavioral and pharmacological interventions over 4 weekly sessions. Measures The attainment of target goals in hemoglobin A1C (A1C), blood pressure, fasting lipids, and tobacco use recommended by the American Diabetes Association.



Of 118 participants, 109 completed the study. VA-MEDIC (n = 58) participants were younger and had greater tobacco use at baseline than usual care but were similar in other cardiovascular risk factors. After 4 months, a greater proportion of VA-MEDIC participants versus controls achieved an A1C of less than 7% and a systolic blood pressure less than 130 mm Hg. No significant change was found in lipid control or tobacco use between the 2 study arms.



Pharmacist-led group medical visits are feasible and efficacious for improving cardiac risk factors.
Taveira
Tracey H
TH
Systems Outcomes and Quality in Chronic disease and Rehabilitation (SOQCR), Research Enhancement Award Program (REAP) Providence VA Medical Center, Providence, Rhode Island (Dr Taveira, Dr Friedmann, Dr Cohen, Dr Dooley, Mr Khatana, Dr Pirraglia, Dr Wu)|Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston (Dr Taveira, Dr Cohen, Dr Dooley)
Friedmann
Peter D
PD
Systems Outcomes and Quality in Chronic disease and Rehabilitation (SOQCR), Research Enhancement Award Program (REAP) Providence VA Medical Center, Providence, Rhode Island (Dr Taveira, Dr Friedmann, Dr Cohen, Dr Dooley, Mr Khatana, Dr Pirraglia, Dr Wu)|Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Dr Friedmann, Dr Pirraglia, Dr Wu)
Cohen
Lisa B
LB
Systems Outcomes and Quality in Chronic disease and Rehabilitation (SOQCR), Research Enhancement Award Program (REAP) Providence VA Medical Center, Providence, Rhode Island (Dr Taveira, Dr Friedmann, Dr Cohen, Dr Dooley, Mr Khatana, Dr Pirraglia, Dr Wu)|Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston (Dr Taveira, Dr Cohen, Dr Dooley)
Dooley
Andrea G
AG
Systems Outcomes and Quality in Chronic disease and Rehabilitation (SOQCR), Research Enhancement Award Program (REAP) Providence VA Medical Center, Providence, Rhode Island (Dr Taveira, Dr Friedmann, Dr Cohen, Dr Dooley, Mr Khatana, Dr Pirraglia, Dr Wu)|Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston (Dr Taveira, Dr Cohen, Dr Dooley)
Khatana
Sameed Ahmed M
SA
Systems Outcomes and Quality in Chronic disease and Rehabilitation (SOQCR), Research Enhancement Award Program (REAP) Providence VA Medical Center, Providence, Rhode Island (Dr Taveira, Dr Friedmann, Dr Cohen, Dr Dooley, Mr Khatana, Dr Pirraglia, Dr Wu)
Pirraglia
Paul A
PA
Systems Outcomes and Quality in Chronic disease and Rehabilitation (SOQCR), Research Enhancement Award Program (REAP) Providence VA Medical Center, Providence, Rhode Island (Dr Taveira, Dr Friedmann, Dr Cohen, Dr Dooley, Mr Khatana, Dr Pirraglia, Dr Wu)|Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Dr Friedmann, Dr Pirraglia, Dr Wu)
Wu
Wen-Chih
WC
Systems Outcomes and Quality in Chronic disease and Rehabilitation (SOQCR), Research Enhancement Award Program (REAP) Providence VA Medical Center, Providence, Rhode Island (Dr Taveira, Dr Friedmann, Dr Cohen, Dr Dooley, Mr Khatana, Dr Pirraglia, Dr Wu)|Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Dr Friedmann, Dr Pirraglia, Dr Wu)
D001071:Appointments and Schedules; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006331:Heart Diseases / Q000517:prevention & control; D006801:Humans; D008055:Lipids / Q000097:blood; D010349:Patient Compliance; D010353:Patient Education as Topic; D018579:Patient Selection; D010595:Pharmacists
D006442:Glycated Hemoglobin; D008055:Lipids