title: Pharmacist-provided diabetes management and education via a telemonitoring program.
abstract: OBJECTIVE
  To assess clinical outcomes (glycosylated hemoglobin [A1C], blood pressure, and lipids) and other measurements (disease state knowledge, adherence, and self-efficacy) associated with the use of approved telemonitoring devices to expand and improve chronic disease management of patients with diabetes, with or without hypertension.
  
  
  METHODS
  Four community health centers (CHCs) in Utah.
  
  
  METHODS
  Federally qualified safety net clinics that provide medical care to underserved patients.
  
  
  METHODS
  Pharmacist-led diabetes management using telemonitoring was compared with a group of patients receiving usual care (without telemonitoring).
  
  
  METHODS
  Daily blood glucose (BG) and blood pressure (BP) values were reviewed and the pharmacist provided phone follow-up to assess and manage out-of-range BG and BP values.
  
  
  RESULTS
  Changes in A1C, BP, and low-density lipoprotein (LDL) at approximately 6 months were compared between the telemonitoring group and the usual care group. Patient activation, diabetes/hypertension knowledge, and medication adherence were measured in the telemonitoring group.
  
  
  RESULTS
  Of 150 patients, 75 received pharmacist-provided diabetes management and education via telemonitoring, and 75 received usual medical care. Change in A1C was significantly greater in the telemonitoring group compared with the usual care group (2.07% decrease vs. 0.66% decrease; P <0.001). Although BP and LDL levels also declined, differences between the two groups were not statistically significant. Patient activation measure, diabetes/hypertension knowledge, and medication adherence with antihypertensives (but not diabetes medications) improved in the telemonitoring group.
  
  
  CONCLUSIONS
  Pharmacist-provided diabetes management via telemonitoring resulted in a significant improvement in A1C in federally qualified CHCs in Utah compared with usual medical care. Telemonitoring may be considered a model for providing clinical pharmacy services to patients with diabetes.
authors.forename: Laura
authors.initials: L
authors.lastname: Shane-McWhorter
authors.forename: Carrie
authors.initials: C
authors.lastname: McAdam-Marx
authors.forename: Leslie
authors.initials: L
authors.lastname: Lenert
authors.forename: Marta
authors.initials: M
authors.lastname: Petersen
authors.forename: Sarah
authors.initials: S
authors.lastname: Woolsey
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Coursey
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Whittaker
authors.forename: Christian
authors.initials: C
authors.lastname: Hyer
authors.forename: Deb
authors.initials: D
authors.lastname: LaMarche
authors.forename: Patricia
authors.initials: P
authors.lastname: Carroll
authors.forename: Libbey
authors.initials: L
authors.lastname: Chuy
mesh_terms: D003920:Diabetes Mellitus / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D010353:Patient Education as Topic; D010595:Pharmacists; D016896:Treatment Outcome; D014589:Utah
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008055:Lipids