title: Pharmacist-physician collaboration for diabetes care: the diabetes initiative program.
abstract: BACKGROUND
  Multiple complications can arise secondary to poor control of glucose, blood pressure, and cholesterol in a patient with diabetes.
  
  
  OBJECTIVE
  To evaluate the effect of a pharmacist-physician collaboration on attainment of diabetes-related measures of control.
  
  
  METHODS
  This was a prospective, multicenter, cohort study. Patients were enrolled from 7 practice sites throughout Tennessee if they had been diagnosed with type 2 diabetes, were aged 18 years or older with a life expectancy greater than 1 year, and were English speaking. Pregnant women were excluded. Patients were followed for 12 months following enrollment by informed consent. The pharmacist-physician collaboration method was established prior to study initiation. Primary outcomes included hemoglobin A1c (A1C), number of patients with A1C less than 7%, and percentage of patients with A1C greater than 9%.
  
  
  RESULTS
  Of the 206 patients enrolled, the mean age was 59.73 years, and most were male (59.71%) and white (66.02%). The A1C was reduced by an average of 1.16% (p < 0.0001). The proportion of patients with A1C less than 7% increased from 12.75% at baseline to 36.76% at study conclusion (p = 0.0002). The proportion of patients with A1C greater than 9% decreased from 34.15% to 16.50%, (p < 0.0001).
  
  
  CONCLUSIONS
  Pharmacist-physician collaborative management at multiple practice locations and types of setting (eg, private, academic, Veterans Affairs medical center) has a positive impact on glycemic control and diabetes-related health maintenance. This was accomplished without increasing the total number of antihyperglycemic agents prescribed and without an increase in patient-reported episodes of hypoglycemia.
authors: College of Pharmacy, Health Science Center, University of Tennessee, Knoxville Campus, Knoxville, TN, USA. mfarland@uthsc.edu
authors: Michelle Zingone
authors: MZ
authors: Farland
authors: Debbie C
authors: DC
authors: Byrd
authors: M Shawn
authors: MS
authors: McFarland
authors: Jeremy
authors: J
authors: Thomas
authors: Andrea S
authors: AS
authors: Franks
authors: Christa M
authors: CM
authors: George
authors: Benjamin N
authors: BN
authors: Gross
authors: Alexander B
authors: AB
authors: Guirguis
authors: Katie J
authors: KJ
authors: Suda
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003299:Cooperative Behavior; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000592:standards; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D010820:Physicians; D011446:Prospective Studies
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human