title: Optimal diabetes care outcomes following face-to-face medication therapy management services.
abstract: Pharmacists play an integral role in influencing resolution of drug-related problems. This study examines the relationship between a pharmacist-led and delivered medication therapy management (MTM) program and achievement of Optimal Diabetes Care benchmarks. Data within Fairview Pharmacy Services were used to identify a group of patients with diabetes who received MTM services during a 2007 demonstration project (n=121) and a control group who were invited to receive MTM services but opted out (n=103). Rates of achieving optimal diabetes clinical management for both groups were compared using the D5 diabetes measure for years 2006, 2007, and 2008. The D5 components are: glycosolated hemoglobin (HbA1c<7%); low-density lipoprotein (<100 mg/dl); blood pressure (<130/80 mmHg); tobacco free; and daily aspirin use. Multivariate difference-in-differences (DID) estimation was used to determine the impact of 1 year of MTM services on each care component. Patients who opted in for MTM had higher Charlson scores, more complex medication regimens, and a higher percentage of diabetes with complications (P<0.05). In 2007, the percentage of diabetes patients optimally managed was significantly higher for MTM patients compared to 2006 values (21.49% vs. 45.45%, P<0.01). Nonlinear DID models showed that MTM patients were more likely to meet the HbA1c criterion in 2007 (odds ratio: 2.48, 95% confidence interval [CI]: 1.04-5.85, P=0.038). Linear DID models for HbA1c showed a mean reduction of 0.54% (95% CI: 0.091%-0.98%, P=0.018) for MTM patients. An MTM program contributed to improved optimal diabetes management in a population of patients with complex diabetes clinical profiles.
authors.affiliation: Fairview Pharmacy Services, Minneapolis, Minnesota, USA.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Brummel
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Soliman
authors.forename: Angeline M
authors.initials: AM
authors.lastname: Carlson
authors.forename: Djenane Ramalho
authors.initials: DR
authors.lastname: de Oliveira
mesh_terms: D003157:Community Pharmacy Services / Q000592:standards*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D054524:Medicare Part D; D054539:Medication Therapy Management / Q000592:standards*; D008875:Middle Aged; D014481:United States
chemical_list: D007004:Hypoglycemic Agents