Clinical and economic impact of a diabetes clinical pharmacy service program in a university and primary care-based collaboration model
| Autor: | Nicole Paolini Albanese, Erin M. Slazak, Martin H. Adelman, Joseph A. Paladino, Scott V. Monte, Gauri Rao |
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| Rok vydání: | 2009 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Universities Medication Therapy Management Psychological intervention New York Pharmacology (nursing) Pharmacy Type 2 diabetes Pharmacotherapy Diabetes mellitus Outcome Assessment Health Care medicine Humans Longitudinal Studies Cooperative Behavior Glycated Hemoglobin Pharmacology Primary Health Care business.industry Managed Care Programs Primary care physician Health Care Costs medicine.disease Clinical pharmacy Models Economic Diabetes Mellitus Type 2 Emergency medicine Physical therapy Group Practice business Pharmacy Service Hospital Body mass index Cohort study |
| Zdroj: | Journal of the American Pharmacists Association : JAPhA. 49(2) |
| ISSN: | 1544-3450 |
| Popis: | Objective To provide program methodology and outcomes data identifying the impact of clinical pharmacy services (CPSs) in patients with type 2 diabetes. Design Longitudinal pre–post cohort study. Setting Regional primary care group in Buffalo, NY, during 2006–2007. Patients Patients with type 2 diabetes identified by their primary care providers were referred to the MedSense program; a pharmacist-led, patient-centered pharmacotherapy management program developed through university collaboration with a regional primary care physician group. Interventions Education, clinical assessments, provider recommendations, and longitudinal follow-up of treatment goals provided by MedSense pharmacists. Main outcome measures Clinical outcomes were followed for 1 year from the index date for primary diabetes endpoints (glycosylated hemoglobin and fasting plasma glucose) and accompanying metabolic parameters (body mass index, blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides). Economic endpoints from the payer perspective were also followed for 1 year from the index date for medical and prescription-related costs. Results Primary diabetes endpoints were significantly reduced versus baseline at the 6-month (−1.1%; P P = 0.003) and 12-month (−1.1%; P P = 0.005) assessments. Improvement rates were observed for all accompanying metabolic parameters at each assessment (range 40–64%). Geometric mean costs tended to decrease versus baseline at 6-month (−$84; P = 0.785) and 12-month (−$216; P = 0.414) assessments, despite nominal increases in diabetes and total medication costs. Conclusion In this CPS model, there were initial and sustained reductions in the primary diabetes endpoints and a high rate of improvement for accompanying metabolic parameters. Concurrent with clinical improvements, total direct medical costs were reduced despite an increase in antidiabetic medication and total medication costs. |
| Databáze: | OpenAIRE |
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