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Clinical Reports |
DAVID M. SCOTT, M.P.H., PH.D., is Associate Professor, Department of Pharmacy Practice, College of Pharmacy, North Dakota State University, Fargo; at the time of this study he was Associate Professor, Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center (UNMC), Omaha. STEVEN T. BOYD, PHARM.D., BCPS, CDE, CDM, is Clinical Pharmacist and Clinical Assistant Professor, UNMC; at the time of this study he was Instructor, Department of Pharmacy Practice, College of Pharmacy, UNMC, and Clinical Pharmacist, Siouxland Community Health Center (SCHC), Sioux City, IA. MICHELLE STEPHAN, R.N., CEO, is Quality Coordinator, SCHC. SAM C. AUGUSTINE, PHARM.D., is Associate Professor, Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University, Omaha; at the time of this study he was Associate Professor, Department of Pharmacy Practice, College of Pharmacy, UNMC. THOMAS P. REARDON, M.A., is Senior Programming Analyst, Academic Computing, Information Technology Services, UNMC.
Address correspondence to Dr. Scott at the College of Pharmacy, North Dakota State University, 118K Sudro Hall, Fargo, ND 58105 (david.scott{at}ndsu.edu).
Methods. Eligible patients were over age 18 years and had a diagnosis of type 2 diabetes mellitus. Patients were randomly assigned by the clinical pharmacist and nurse to the intervention group (n = 76) or control group (n = 73). Patients in the intervention group were enrolled in a pharmacist-managed diabetes care program. Patients in the control group received the standard diabetes care. The primary endpoint was reduction in glycosylated hemoglobin (HbA1c); secondary outcome measures included weight loss, an improved body mass index, decreased blood pressure, and an improved lipid panel. Quality-of-life measures (health level, satisfaction, impact, worry about disease, and worry about social and vocational issues) were also assessed.
Results. Demographic differences between groups were not remarkable. Mean HbA1c levels fell significantly (p < 0.05) from baseline to nine months in both groups. A diff erence of 1.0 was reported between the groups’ HbA1c levels (95% confidence interval, 0.08–1.78; p < 0.05). Satisfaction level improved from 63.7 to 77.4 in the intervention group, which was significant when compared with the control group, whose satisfaction score improved from 57.0 to 63.4 (p < 0.05).
Conclusion. Patients with type 2 diabetes mellitus who received pharmacist-managed diabetes care demonstrated improved HbA1c, systolic blood pressure, and low-density-lipoprotein cholesterol levels and quality-of-life measures and met treatment goals more often than patients receiving standard care.
Index terms: Ambulatory care; Clinical pharmacists; Diabetes mellitus; Interventions; Pharmaceutical services; Quality of life
Purpose. The outcomes of pharmacistmanaged diabetes care services in a community health center were studied.
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