Changes in clinical markers observed from pharmacist-managed cardiovascular risk reduction clinics in federally qualified health centers: A retrospective cohort study.

Autor: Gonzalvo JD; Purdue University College of Pharmacy, Indianapolis, Indiana, United States of America., Meredith AH; Purdue University College of Pharmacy, Indianapolis, Indiana, United States of America., Pastakia SD; Purdue University College of Pharmacy, Indianapolis, Indiana, United States of America., Peters M; Eskenazi Health, Indianapolis, Indiana, United States of America., Eberle M; Purdue University College of Pharmacy, Indianapolis, Indiana, United States of America., Schmelz AN; Butler University College of Pharmacy and Health Sciences, Indianapolis, Indiana, United States of America., Pence L; Eskenazi Health, Indianapolis, Indiana, United States of America., Triboletti JS; Butler University College of Pharmacy and Health Sciences, Indianapolis, Indiana, United States of America., Walroth TA; Eskenazi Health, Indianapolis, Indiana, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Mar 15; Vol. 18 (3), pp. e0282940. Date of Electronic Publication: 2023 Mar 15 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0282940
Abstrakt: Background: Reductions in hemoglobin A1c (HbA1C) have been associated with improved cardiovascular outcomes and savings in medical expenditures. One public health approach has involved pharmacists within primary care settings. The objective was to assess change in HbA1C from baseline after 3-5 months of follow up in pharmacist-managed cardiovascular risk reduction (CVRR) clinics.
Methods: This retrospective cohort chart review occurred in eight pharmacist-managed CVRR federally qualified health clinics (FQHC) in Indiana, United States. Data were collected from patients seen by a CVRR pharmacist within the timeframe of January 1, 2015 through February 28, 2020. Data collected include: demographic characteristics and clinical markers between baseline and follow-up. HbA1C from baseline after 3 to 5 months was assessed with pared t-tests analysis. Other clinical variables were assessed and additional analysis were performed at 6-8 months. Additional results are reported between 9 months and 36 months of follow up.
Results: The primary outcome evaluation included 445 patients. Over 36 months of evaluation, 3,803 encounters were described. Compared to baseline, HbA1C was reduced by 1.6% (95%CI -1.8, -1.4, p<0.01) after 3-5 months of CVRR care. Reductions in HbA1C persisted at 6-8 months with a reduction of 1.8% ([95%CI -2.0, -1.5] p<0.01). The follow-up losses were 29.5% at 3-5 months and 93.2% at 33-36 months.
Conclusions: Our study augments the existing literature by demonstrating the health improvement of pharmacist-managed CVRR clinics. The great proportion of loss to follow-up is a limitation of this study to be considered. Additional studies exploring the expansion of similar models may amplify the public health impact of pharmacist-managed CVRR services in primary care sites.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Gonzalvo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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