Adults with type 2 diabetes improve HbA1c, medication use with pharmacist referral
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Key takeaways:
- Mean HbA1c declined by 1.9 percentage points for adults with type 2 diabetes who saw a clinical pharmacist.
- More than half of adults in the pharmacy group reached their HbA1c goal by the end of the study.
Adults with type 2 diabetes who are referred to a clinical pharmacist are more likely to meet their HbA1c goal and receive appropriate medication management of comorbidities than people receiving usual care, according to a presenter.
Jarred Prudencio, PharmD, BCACP, BC-ADM, associate professor of pharmacy practice at the Daniel K. Inouye College of Pharmacy at University of Hawaii at Hilo, presented data from adults with type 2 diabetes attending a single primary care clinic and compared data from people who were seen by a clinical pharmacist with those not seen by a clinical pharmacists. Adults who attended a clinical pharmacy service had a larger decline in HbA1c during the study and were more likely to be prescribed medication for cardiovascular or renal comorbidities.
“The addition of integrated clinical pharmacists into interdisciplinary team-based primary care service models improves medication optimization use for patients with diabetes,” Prudencio told Healio.
Prudencio collected electronic medical records of 679 adults with type 2 diabetes seen at East Hawaii Health Clinic from 2021 to 2023. The study group included 180 adults who attended a clinical pharmacy service and 499 adults receiving usual care who were not seen by clinical pharmacy service. HbA1c, medications and comorbidities were collected.
The findings were presented at the Association of Diabetes Care and Education Specialists annual meeting.
Adults attending a clinical pharmacy service had a decline in mean HbA1c from 10% at baseline to 8.1% at the end of the study compared with a decrease in HbA1c from 8% at baseline to 7.5% at the end of the study for adults receiving usual care. The proportion of adults attending a clinical pharmacist achieving their HbA1c goal increased from 16.1% at baseline to 56.1% at the end of the study. Among adults receiving usual care, 44.9% were meeting their HbA1c goal at baseline. That percentage increased slightly to 48.4% at the end of the study.
Atherosclerotic cardiovascular disease (ASCVD) was prevalent among 28.3% of adults attending a clinical pharmacist compared with 17.4% of those receiving usual care. Of those with ASCVD, 68.6% of adults in the pharmacy group were prescribed a GLP-1 receptor agonist or SGLT2 inhibitor compared with 23.3% of those receiving usual care.
Chronic kidney disease was diagnosed in 34.4% of adults attending the clinical pharmacy service and 11.5% of those in the usual care group. An SGLT2 inhibitor was prescribed for 41.9% of adults with CKD in the pharmacy group vs. 16.7% of those with CKD receiving usual care.
The proportion of adults with heart failure was 16.7% in the pharmacy group compared with 7.4% in the usual care group. Of those with heart failure, 60% attending the clinical pharmacy service were prescribed an SGLT2 inhibitor compared with 35.5% of adults receiving usual care.
“There’s a ton of data out there that shows that the addition of a pharmacist into team-based care models has shown improvements in patient outcomes,” Prudencio said. “Further research could dive into more logistics of pharmacist integration and best practice models in terms of workflow, care coordination and innovative billing models to support pharmacist integration from the financial standpoint.”
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Prudencio J. P-301. Presented at: ADCES24; Aug, 9-12, 2024; New Orleans.
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