Journal of American Pharmacists Association

Abstract

Objective To measure the impact of an employer-sponsored, pharmacist-provided medication therapy management (MTM) program on clinical outcomes and social and process measures for patients with diabetes with or without associated comorbid conditions.

Methods Prospective longitudinal study that took place at seven independent pharmacies in Lucas County, OH. A total of 228 patients with diabetes were enrolled. At 6-month intervals, patients were counseled by their pharmacists. Outcome measures included clinical outcomes (glycosylated hemoglobin [A1C], systolic blood pressure (SBP), and diastolic blood pressure [DBP]), social measures (caffeine intake, alcohol consumption, smoking, and exercise), and process measures (visits to ophthalmologist, podiatrist, and dentist). Wilcoxon signed–rank test and percentages were used to report findings.

Results Mean (±SD) A1C concentration decreased from 7.08 ± 1.54% to 6.89 ± 1.30% at 12 months. Patients with A1C levels greater than 7% at baseline averaged a decrease of 0.5% at 6 months and 0.75% at 12 months. Mean SBP values decreased significantly from baseline to 12 months. A total of 87 patients with a baseline SBP greater than 130 mm Hg experienced a significant change in blood pressure from baseline to 6 months (−7.1 ± 3.32 mm Hg), and 65 patients experienced a significant change in blood pressure from baseline to 12 months (−11.49 ± 0.15 mm Hg). A total of 104 patients with a baseline DBP more than 80 mm Hg experienced a significant decrease of 4.44 ± 1.25 mm Hg at 6 months. Caffeine and alcohol consumption and smoking decreased and exercise increased. In addition, the percentage of patients who visited specialists increased.

Conclusion Patients with diabetes experienced improvements in multiple clinical, social, and process measures.

APhA Members
Welcome to JAPha.org! Please log in below using your APhA username and password. If you need to update your account information, please go to Pharmacists.org and login using your current credentials.

Username

Password

Forgot your password?

New to JAPhA? Become an APhA member to receive a full subscription to both the print and online editions.

Buy 7-day-access to this article for $30
Buy 7-day-access to this issue for $75
Buy 7-day-access to JAPhA Online for $150

OR

Register for a FREE limited account to benefit from personalization features such as alerts.

References

1

Centers for Disease Control and Prevention. Diabetes successes and opportunities for population-based prevention and control: at a glance 2010. Atlanta, GA: Centers for Disease Control and Prevention; 2010.

2

Planas LG, Crosby KM, Mitchell KD, et al. Evaluation of a hypertension medication therapy management program in patients with diabetes. J Am Pharm Assoc. 2009;49:164–70.[CrossRef]

3

Cranor C, Bunting B, Christensen DB. The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43:173–84.

4

Bunting B, Smith B, Sutherland SE. The Asheville Project: clinical and economic outcomes of a community-based long-term medication therapy management program for hypertension and dyslipidemia. J Am Pharm Assoc. 2008;48:23–31.

5

Fera T, Bluml BM, Ellis WM. Diabetes Ten City Challenge: final economic and clinical results. J Am Pharm Assoc. 2009;49:383–91.

6

Johannigman MJ, Leifheit M, Bellman N, et al. Medication therapy management and condition care services in a community-based employer setting. Am J Health Syst Pharm. 2010;67:1362–7.

7

Wagner E, Sandhu N, Newton K, et al. Effect of improved glycemic control on health care cost and utilization. JAMA. 2001;285:182–9.

8

Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–12.

9

Moisey L, Kacker S, Bickerton A, et al. Caffeinated coffee consumption impairs blood glucose homeostasis in response to high and low glycemic index meals in healthy men. Am J Clin Nutr. 2008;87:1254–61.

10

Campbell NR, Ashley MJ, Carruthers SG. Lifestyle modifications to prevent and control hypertension: recommendations on alcohol consumption. CMAJ. 1999;160(9 suppl):S13–20.

11

Eliasson B. Cigarette smoking and diabetes. Prog Cardiovasc Dis. 2003;45:405–13.

12

Mealey BL, Oates TW. Diabetes mellitus and periodontal diseases. J Periodontol. 2006;77:1289–303.

13

Macek MD, Taylor GW, Tomar SL. Dental care visits among dentate adults with diabetes, United States, 2003. J Public Health Dent. 2008;68:102–10.

14

Odegard PS, Goo A, Hummel J, et al. Caring for poorly controlled diabetes mellitus: a randomized pharmacist intervention. Ann Pharmacother. 2005;39:433–40.

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).

Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.

All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Please read the other comments before you post yours. Comments are moderated and will appear on the site at the discertion of the editorial staff.
* = Required Field

Comment Author(s)*(if multiple authors, separate names by comma)

Example: John Doe

Affiliation & Institution*

Comment Title*

Comment*