To demonstrate that pharmacists working with physicians and other providers in an ambulatory care setting can improve glucose, blood pressure, and lipid control for patients with type 2 diabetes and to report patient adherence to screening and general preventive measures.
Prospective, randomized, clinical practice study.
Burlington, MA, between January 2001 and August 2003.
164 patients patients with type 2 diabetes older than 18 years with glycosylated hemoglobin (A1C) greater than 8%.
Pharmacist–patient clinic visits included obtaining a comprehensive medication review; performing targeted physical assessment; ordering laboratory tests; reviewing, modifying, and monitoring patients’ medication therapy and providing detailed counseling on all therapies; facilitating self-monitoring of blood glucose; and providing reinforcement of dietary guidelines and exercise.
Main outcome measure
Effect of clinical pharmacists working with physicians in an ambulatory setting on health measures (e.g., A1C, blood pressure, cholesterol) of patients with diabetes.
Baseline characteristics were similar between the two groups. After 1 year, significant improvements occurred for A1C and low-density lipoprotein (LDL) cholesterol in the intervention group compared with the control group (A1C, 7.7% vs. 8.4%; LDL, 93.7 vs. 105.1 mg/dL;
P < 0.05). Systolic blood pressure improved for all study patients without a difference between the two groups. Diastolic blood pressure improved significantly in the intervention group compared with the control group (73.4 mm Hg vs. 77.6 mm Hg,
P < 0.05). Significantly more intervention patients were screened for retinopathy, neuropathy, and microalbuminuria than control patients (
P < 0.05).
For all indices measured, this study demonstrated that collaborative diabetes management with a clinical pharmacist can improve overall care.