An Effectiveness Study of a Primary Care-embedded Clinical Pharmacist-Led Intervention Among Patients With Diabetes and Medicaid Coverage.
| Autor: | Narain, Kimberly Danae Cauley, Tseng, Chi-Hong, Bell, Douglas, Do, Amanda, Follett, Rob, Duru, O. Kenrik, Moreno, Gerardo, Mangione, Carol |
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| Předmět: |
CARDIOVASCULAR disease prevention
GLYCOSYLATED hemoglobin HYPERTENSION OCCUPATIONAL roles SYSTOLIC blood pressure DIABETES ACQUISITION of data PRIMARY health care HOSPITAL pharmacies PRE-tests & post-tests COMPARATIVE studies DRUGS RESEARCH funding MEDICAL records DESCRIPTIVE statistics MEDICAID PATIENT compliance ELECTRONIC health records MEDICAL appointments STATISTICAL sampling |
| Zdroj: | Journal of Pharmacy Practice; Feb2024, Vol. 37 Issue 1, p66-73, 8p |
| Abstrakt: | Objective: Examine the impact of a primary care-embedded clinical pharmacist-led intervention (UCMyRx) on hemoglobin A1C and blood pressure control, relative to usual care, among patients with Type 2 diabetes (TD2) and Medicaid, in a large healthcare system. Methods: We used data extracted from the Electronic Health Records system and a Difference-In-Differences study design with a 2:1 propensity-matched comparison group to evaluate the impact of UCMyRx on HbA1c and systolic blood pressure among patients with TD2 and Medicaid, relative to usual care. Results: Having at least one UCMyRx clinical pharmacist visit was associated with a significant reduction in HbA1c; (−.27%, P -value=.03) but no impact on SBP. We do not find differential UCMyRx effects on HbA1c or SBP among the subpopulations with baseline HbA1C ≥9% or SBP ≥150 mmHg, respectively. In Charlson Comorbidity Index (CCI)-stratified analyses we found stronger UCMyRx effects on HbA1C (−.47%, P -value<.02) among the CCI tercile with the lowest comorbidity score (CC1 ≤ 5). Significant UCMyRx effects are only observed among the subpopulation of Medicaid beneficiaries without Medicare (−.35%, P -value=.02). Conclusions: The UCMyRx intervention is a useful strategy for improving HbA1c control among patients with TD2 and Medicaid. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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