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Pharmacist-led chronic disease management found comparable to usual care

Chronic disease management led by pharmacists resulted in similar resource utilization compared to usual care, according to research published in the Annals of Internal Medicine.

Nancy Greer, PhD, with the Center for Chronic Disease Outcomes Research at the Veterans Affairs Medical Center, and colleagues also reported a lack of evidence on clinical outcomes and harms from pharmacist-led care.

“Integration of clinical pharmacists in patient care may offer increased access to health care and improved patient outcomes,” Greer and colleagues wrote. “Recently introduced legislation would establish pharmacists as health care providers and enable coverage of pharmacists’ services through Medicare Part B in medically underserved communities. Pharmaceutical care involves pharmacist collaboration with health team members to optimize therapeutic outcomes. Since 1995, the Department of Veterans Affairs has allowed clinical pharmacy specialists an expanded scope of practice, with independent prescribing privileges.”

Greer and colleagues used MEDLINE, the Cochrane Library, CINAHL and International Pharmaceutical Abstracts from 1995 through 2016 to identify 63 studies conducted in the United States with 65 patient populations.

Data analysis showed care led by pharmacists was associated with similar emergency department visits, hospitalizations, urgent care visits and office visits, as well as similar medication adherence, when compared with usual care. Researchers also found patients in pharmacist-led care groups received increased numbers or doses of medications and experienced improved lipid, blood pressure and glycemic goal achievement. In addition, clinical events and mortality were comparable between the two groups. Greer and colleagues reported that evidence regarding any harm was limited and evidence regarding patient satisfaction was insufficient.

“[Pharmacist-led] chronic disease management was associated with effects similar to those of usual care for resource utilization and may improve physiologic goal attainment,” they concluded. “Further research is needed to determine whether increased medication utilization and goal attainment improve clinical outcomes.” – by Chelsea Frajerman Pardes

Disclosures: Greer reports grants from the Department of Veterans Affairs during the conduct of the study. Please see the full study for a complete list of all other authors’ relevant financial disclosures.