Evaluation of factors associated with achieving glycemic control in a pharmacist-managed diabetes clinic.
The aim of this study was to identify factors that are associated with patients achieving goal A1c after 6 months in a pharmacist-managed diabetes clinic. This study is a descriptive, retrospective chart review of patients with type 2 diabetes enrolled in a pharmacist-managed diabetes clinic. The primary endpoint was the odds of each identified factor being associated with achievement of goal A1c after 6 months of enrollment. The factors were also evaluated within 2 subgroups: those with a baseline A1c >7% and those with a baseline A1c >9%. Of 112 patients enrolled, 58 were included in the analysis. There was a positive association with reaching goal for patients who had <1 failure to show (FTS) to office visits in 6 months [odds ratio (OR) 8.10, 95% confidence interval (CI) 1.47-58.65], had canceled or FTS to <50% of office visits (OR 10.0, 95% CI 1.8-72.79), and brought >75% of blood glucose logs to their office visits (OR 7.36, 95% CI 1.87-30.88). There was a negative association with reaching the goal for patients with documented social worker involvement (OR 0.22, 95% CI 0.04-0.99) and noninsulin or insulin dose increases at >50% of office visits (OR 0.10, 95% CI 0.01-0.55). Overall, this analysis found that patients who had <1 FTS, had canceled or FTS to <50% of office visits, or who brought >75% logs to office visits were more likely to achieve goal A1c, whereas patients with social work assistance or dose increases at >50% of office visits were less likely to reach goal A1c.
1Department of Pharmacy, Akron General Medical Center, Akron, OH; and 2Northeast Ohio Medical University, Rootstown, OH.
Matthew D
MD
Kostoff
Melanie L
ML
Boros
John M
JM
Moorman
Lawrence A
LA
Frazee
D000553:Ambulatory Care / Q000458:organization & administration; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D012189:Retrospective Studies; D012947:Social Work / Q000706:statistics & numerical data; D016896:Treatment Outcome
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human