An employer-based, pharmacist intervention model for patients with type 2 diabetes.
OBJECTIVE
Changes in glycosylated hemoglobin (HbA(1c)) levels, blood pressure measurements, and utilization metrics among diabetic patients managed by a clinical pharmacist were studied.


CONCLUSIONS
This pharmacist intervention model was developed by Polk County, Florida, to engage patients with diabetes in managing their health based on the Asheville Project's framework. The diabetes program was implemented in February 2005, with an on-site clinical pharmacist to counsel participants with diabetes. The on-site pharmacist individualized each patient's care. After the initial assessment, educational deficiencies were noted and addressed as needed. Outcomes measured included changes in HbA(1c), blood glucose, and blood pressure values and utilization metrics, such as hospitalization and emergency room visit rates, from baseline to one year after pharmacist intervention. Of the 564 participants who enrolled in the program, 477 were enrolled at the end of one year and were included in the analysis. Results showed that HbA(1c) values steadily decreased over the one-year study period. At baseline, there were 55% of participants with an average HbA(1c) value of < or =7%. After one year, 72% of participants had HbA(1c) values of < or =7%. Participants' mean systolic and diastolic blood pressure values were lower at the end of one year compared with the baseline. Participants also had a 30% reduction in hospital admissions, and the number of emergency room visits during the one-year period decreased by 24%.


CONCLUSIONS
An employer-based pharmacist intervention model for patients with diabetes improved HbA(1c) levels, reduced systolic and diastolic blood pressure values, and decreased hospitalizations and emergency room visits after one year.
Health Care Analytics, CVS Caremark, 2211 Sanders Road, Northbrook, IL 60062, USA. ravi.iyer@caremark.com
Ravi
R
Iyer
Pauline
P
Coderre
Theresa
T
McKelvey
Jason
J
Cooper
Jan
J
Berger
Elizabeth
E
Moore
Mike
M
Kushner
D001786:Blood Glucose / Q000032:analysis; D001795:Blood Pressure Determination; D003376:Counseling / Q000379:methods; D048909:Diabetes Complications / Q000175:diagnosis / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000191:economics; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D009111:Local Government; D017146:Models, Organizational; D009786:Occupational Health Services / Q000458:organization & administration*; D019982:Organizational Case Studies; D010353:Patient Education as Topic / Q000379:methods; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration* / Q000592:standards; D012648:Self Care / Q000379:methods / Q000592:standards; D000078329:Workforce
D001786:Blood Glucose; D006442:Glycated Hemoglobin