Evaluation of a Conservative Pharmacist-led U-500R Insulin Management Protocol in the Primary Care Setting
| Autor: | Connie Valdez, Leah Fitzgerald, Cyndi Dumont |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Colorado medicine.medical_treatment pharmacist Pharmacist Primary care lcsh:Computer applications to medicine. Medical informatics Pharmacists 03 medical and health sciences primary care 0302 clinical medicine Insulin resistance Pharmacotherapy Diabetes mellitus insulin resistance medicine Humans Hypoglycemic Agents Insulin 030212 general & internal medicine Intensive care medicine Retrospective Studies Original Research Community and Home Care Protocol (science) Glycated Hemoglobin Primary Health Care business.industry lcsh:Public aspects of medicine 030503 health policy & services Public Health Environmental and Occupational Health lcsh:RA1-1270 medicine.disease drug therapy U500 Diabetes Mellitus Type 2 collaborative drug therapy management concentrated insulin diabetes mellitus lcsh:R858-859.7 0305 other medical science business Quality assurance Type 2 |
| Zdroj: | Journal of Primary Care & Community Health Journal of Primary Care & Community Health, Vol 11 (2020) |
| ISSN: | 2150-1327 |
| Popis: | Objective The objective of this quality assurance study is to evaluate the impact of a conservative, pharmacist-led, U-500R insulin management protocol on diabetes control (A1c) and total daily dosage requirements between August 2016 and August 2018. Methods This was a retrospective chart review of adult patients, aged 18 to 79, with type 2 diabetes and managed with insulin, at 2 federally qualified healthcare clinics in Denver, Colorado. To determine if our conservative pharmacist-led U-500R insulin management protocol impacted efficacy and total daily dosage requirements when converting patients from U-100 to U-500R insulin, we compared the most effective dose of U-500R (defined as the total daily dose (TDD) of U-500R insulin at A1c goal or the lowest tolerated A1c) to the baseline A1c and TDD of U-100 insulin at time of conversion. Results Following conversion of U-100 to U-500R insulin, patients required an average of 21 fewer units of insulin with U-500R than U-100 and achieved an average A1c of 7.2% which reflected a reduction of 3.5 points from baseline. Five patients (62.5%) achieved A1c goal per ADA guidelines, and all patients achieved at least a 1.7 point reduction in A1c, with 1 patient achieving a 6.7 point reduction. Two patients (25%) were still in the process of U-500R titration at the time of data collection, and 1 patient (12.5%) did not achieve goal A1c while under pharmacy management at these clinics. Four of the five patients who achieved A1c goal did so with an overall reduction in total daily insulin dose (average of 57.5 units less than original U-100 dose) resulting in an average A1c decrease of 3.6 points. |
| Databáze: | OpenAIRE |
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