diabetestalk.net

Pharmacist-run Diabetes Clinic Protocol

Pharmacist And Patient Centered Diabetes Care

Pharmacist And Patient Centered Diabetes Care

Pharmacist and Patient Centered Diabetes Care SCPhA typically hosts this program 1-2 times per year. If you wish to be added to our waiting list, please click here . Courses are typically held from 8:00 AM - 5:00 PM, with registration beginning at 7:30 AM, at the SCPhA Office, 1350 Browning Road in Columbia, SC. Breakfast, lunch and snacks are included with your registration. Due to the self-study portion of this program, all registrations must be received no later than 10 business days prior to the start of the course. About the Pharmacist and Patient Centered Diabetes Care program The Pharmacist and Patient-Centered Diabetes CareCertificate Training Program is a newly revised, intensive educational experience designedto equip pharmacists with the knowledge, skills, and confidence needed to provide effective, evidence-based diabetes care.Five self-study modules provide comprehensive instruction in current diabetes concepts and standards of care. The live seminar incorporates case studies and hands-on skills training focused on the situations most likely to be encounteredas well as the services most neededin community and ambulatory care practice settings. Participants will gain experience evaluating and adjusting drug therapy regimens for patients with type 1 and type 2 diabetes, counseling patients about lifestyleinterventions, analyzing and interpreting self-monitoring of blood glucose results, and assessingthe overall health status of patients to identify needed monitoring and interventions. The goals of the certificate training program are to: Provide comprehensive instruction in current standards of care for patients with diabetes. Increase pharmacists confidence in serving as the drug therapy expert on the diabetes health care team. Refresh pharmacists knowledge Continue reading >>

Impact Of A Pharmacist-managed Diabetes Clinic On Quality Measures

Impact Of A Pharmacist-managed Diabetes Clinic On Quality Measures

Ashby F. Walker, PhD; Jaclyn M. Hall, PhD; Elizabeth A. Shenkman, PhD; Matthew J. Gurka, PhD; Heather L. Morris, PhD; Michael J. Haller, MD; Henry J. Rohrs, MD; Kelsey R. Salazar, MPH; and Desmond A. Schatz, MD Impact of a Pharmacist-Managed Diabetes Clinic on Quality Measures Nadia J. Aneese, PharmD; Alexandra Halalau, MD; Sarah Muench, PharmD; Daniel Shelden, DO; Janna Fett, PharmD; Colleen Lauster, PharmD Evidence-Based Diabetes Management > March 2018 Published on: March 31, 2018 Impact of a Pharmacist-Managed Diabetes Clinic on Quality Measures Nadia J. Aneese, PharmD; Alexandra Halalau, MD; Sarah Muench, PharmD; Daniel Shelden, DO; Janna Fett, PharmD; Colleen Lauster, PharmD This study evaluated a pharmacist-managed diabetes clinic to determineits impact on diabetes-related quality measures.(For Tables and Figures, please access thePDF on last page.) A pharmacist-managed diabetes clinic (PMDC) was created to assist with improvement of diabetes quality measures.The objective was to evaluate the PMDC impact on quality measures. According to the CDC 2017 National Diabetes Statistics Report, diabetes was theseventh leading cause of death in 2015.1 Additionally, diabetes is associated withsignificant morbidity leading to a high burden on healthcare costs. Tools are used toevaluate provider performance on this costly disease. The Healthcare EffectivenessData and Information Set (HEDIS) developed by the National Committee for QualityAssurance (NCQA) is 1 tool with defined diabetes care criteria.2 These criteria includecurrent glycated hemoglobin testing (A1C), A1C control (<8%), current retinal or dilatedeye exam, blood pressure control (<140/90 mmHg), and nephropathy monitoring. The NCQA maintains Recognition Programs such as the Patient-CenteredMedical Home designatio Continue reading >>

Pharmacist-led Self-management Interventions To Improve Diabetes Outcomes. A Systematic Literature Review And Meta-analysis

Pharmacist-led Self-management Interventions To Improve Diabetes Outcomes. A Systematic Literature Review And Meta-analysis

Pharmacist-Led Self-management Interventions to Improve Diabetes Outcomes. A Systematic Literature Review and Meta-Analysis We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Pharmacist-Led Self-management Interventions to Improve Diabetes Outcomes. A Systematic Literature Review and Meta-Analysis Linda van Eikenhorst, Katja Taxis, [...], and Han de Gier Background: Treatment of diabetes requires a strict treatment scheme which demands patient self-management. Pharmacists are in a good position to provide self-management support. This review examines whether pharmacist-led interventions to support self-management in diabetes patients improve clinical and patient-reported outcomes. Methods: This review was conducted according to the PRISMA guidelines. An extended literature search was conducted with the keywords pharmacist, diabetes, and self-management using the electronic databases Pubmed, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane Library from the beginning of the database through September 2017. In addition reference lists of systematic reviews and included studies were searched. Eligibility criteria included; self-management intervention tested with an RCT, performed in an ambulatory care setting, led by a pharmacist and reporting at least one clinical- or patient-reported outcome. Primary outcomes were HbA1c (as this is a clinical parameter for long-term diabetes follow-up), self-management and components of in Continue reading >>

Project Impact: Diabetes

Project Impact: Diabetes

Jefferson County Department of Health (JCDH) has a stated mission to prevent disease and assure access to quality health care, promote a healthy lifestyle and a healthy environment, and protect against public health threats. JCDH provides outpatient health care for Jefferson Countys underinsured and uninsured residents at six health centers located throughout Jefferson County, Alabama. In some cases at these clinics, physicians and pharmacists visit with patients together and work as a team to develop health goals and care plans. Project IMPACT: Diabetes was integrated into three pharmacist-run diabetes clinics in JCDH health centers. Patients with diabetes benefit from in-depth coaching and education provided through a pharmacist-run diabetes clinic. The clinic has a five visit protocol which the patients experience at different visits four to six weeks apart. JCDH has partnered with Samford University McWhorter School of Pharmacy and Cooper Green Mercy Hospital through Project IMPACT: Diabetes to provide enhanced care to diabetes patients. Patients consist of individuals who enter the program with uncontrolled diabetes. Most of the patients that are seen at the site have baseline A1Cs greater than 9%. The patient population is largely uninsured and unemployed, and many are poverty-stricken. Health literacy is also a concern with these patients. Pharmacists Role on the Collaborative Care Team Pharmacists participate directly with other healthcare providers during patient visits, performing medication histories, collaborating in decision making and discussions, and educating patients. Patients are enrolled in the diabetes clinic upon identification by the team during provider visits, by provider referral, or identification by the pharmacist team using EMR reporting. On Continue reading >>

A Pharmacy Studentfacilitated Interprofessional Diabetes Clinic With The Penobscot Nation

A Pharmacy Studentfacilitated Interprofessional Diabetes Clinic With The Penobscot Nation

A Pharmacy StudentFacilitated Interprofessional Diabetes Clinic With the Penobscot Nation COMMUNITY CASE STUDY Volume 12 November 5, 2015 Sarah Levin Martin, PhD; Evan Williams, PharmD; Benjamin Huerth, MD; J. Daniel Robinson, PharmD; for the Penobscot Nation Health Centers Diabetes Team Suggested citation for this article: Martin SL, Williams E, Huerth B, Robinson JD, for the Penobscot Nation Health Centers Diabetes Team. A Pharmacy StudentFacilitated Interprofessional Diabetes Clinic With the Penobscot Nation. Prev Chronic Dis 2015;12:150295. DOI: . American Indians/Alaska Natives have a greater increased risk for diabetes than non-Hispanic whites. Lifestyle interventions are effective in preventing and treating diabetes, and an interprofessional approach is important in diabetes management. The Penobscot Nation has a health center with a wide range of services. Our goal with the Nation was to 1) establish an interprofessional, student-facilitated diabetes clinic in the health center; 2) assess the clinics preliminary impact. Relationship building and problem solving was instrumental in working toward the first goal. A survey was developed to assess satisfaction with the clinic. The clinical outcomes, mean and median values of HbA1c, were calculated at baseline (spring 2013) and were used to establish 2 groups of patients: those with controlled levels (<7%) and those with uncontrolled levels ( 7%). HbA1c was reassessed in fall 2013. Changes in HbA1c were calculated and compared using the Wilcoxon signed-rank test. The student-facilitated, interprofessional diabetes clinic has operated for 2 years, and changes are under way. More than 90% of participants reported being well satisfied with the clinic in the first year. Among the group with uncontrolled HbA1c (n = 18), Continue reading >>

Pharmacist Follow-ups Cut Diabetes Costs And Reduce Health Risks

Pharmacist Follow-ups Cut Diabetes Costs And Reduce Health Risks

Pharmacist follow-ups cut diabetes costs and reduce health risks April 20, 2018, National University of Singapore Two studies led by Associate Professor Joyce Lee from the Department of Pharmacy at the National University of Singapore's (NUS) Faculty of Science revealed that pharmacist-managed care, in addition to routine check-ups with physicians, help improve the management of diabetes and the associated chronic diseases. NUS researchers found that people with type 2 diabetes who regularly saw Ambulatory Care pharmacists (i.e. pharmacists specially trained in chronic disease management) experienced better control of blood sugar levels and maintained good blood pressure and cholesterol values. They also spent less on healthcare due to less frequent visits to the doctor for poor health pertaining to diabetic-related diseases. In addition, among people with type 2 diabetes who also have other cardiac health issues such as heart failure or stroke, those who had enrolled in the pharmacist-managed care services were three times less likely to be admitted to the hospital than those who did not. Assoc Prof Lee said, "With the increasing prevalence of diabetes, the physician-centred model is challenged to deliver holistic care in Asia. Diabetes and its associated chronic diseases may be managed effectively within a multidisciplinary collaborative care model. However, evidence on its effectiveness in Asian patients is lacking. Our two studies illustrate the positive impact of multidisciplinary collaborative care involving pharmacists, hence supporting the effectiveness of this approach in managing chronic diseases." Better management of diabetes through pharmacist-involved multidisciplinary collaborative care Associate Professor Lee and her research team conducted a six-month Continue reading >>

Pharmacist-led Group Medical Visits To Help With Diabetes Management (medic-1)

Pharmacist-led Group Medical Visits To Help With Diabetes Management (medic-1)

Other: Algorithm driven medication titration Behavioral: Monitoring Behavioral: Group support Behavioral: Self efficacy Project Background: Diabetes, hypertension, and dyslipidemia are chronic diseases that can lead to heart attack and stroke, and require interventions at patient and organizational levels to promote sustainable lifestyle and medication changes for cardiac risk reduction that are costly. Group intervention has emerged as a potentially cost-saving patient-centered approach to help achieve the necessary lifestyle and medication changes for the treatment of some chronic diseases, but its efficacy in absence of direct physician participation is not well demonstrated in diabetes. Our preliminary data have shown that our pharmacist-based, group diabetes management program at the Providence VAMC has achieved significant improvements in glycemic control and variable success toward improvement in blood pressure and lipid control in type 2 diabetic patients, through education, behavioral intervention and aggressive pharmacotherapy in 4 weekly group sessions. However, we do not know the long-term sustainability of this intervention, the exportability, the costs to the VA and the health-related quality-of-life implications of patients enrolled in our programs. Project Objectives: To assess whether a non-physician-based, group diabetes behavioral and pharmacotherapy intervention program for 12 months will: 1. improve cardiac risk factors, 2. improve health-related quality-of-life, 3. add only minimal institutional cost; when compared to usual care in veterans with type 2 diabetes. Project Methods: We propose a 3-site randomized-controlled study to test the efficacy of a pharmacist-based, group diabetes behavioral and pharmacotherapy intervention program (treatment a Continue reading >>

Va Pharmacist-led Diabetes Clinic Dramatically Improves Patient Outcomes

Va Pharmacist-led Diabetes Clinic Dramatically Improves Patient Outcomes

VA Pharmacist-Led Diabetes Clinic Dramatically Improves Patient Outcomes Candis M. Morello, Pharm.D., CDE, FCSHP, FASHP BACK IN 2009, when the VA San Diego Healthcare System wanted to help its primary care physicians meet performance measures for diabetes as well as help its patients with diabetes improve their metabolic goals, Candis M. Morello, Pharm.D., CDE, FCSHP, FASHP, saw an opportunity to apply her knowledge as both a pharmacist and diabetes educator. Working together with the departments of endocrinology, internal medicine, and pharmacy, she devised the Diabetes Intense Medical Management Clinic, a pharmacist-led clinic that delivers individualized diabetes care. The new model provides integrated care that covers not only diabetes, but hypertension, lipids, food choices, activity, mood, adherence, and motivation. We then put it all together to create a unique treatment plan for each patient, said Dr. Morello, who is professor of clinical pharmacy and associate dean for student affairs at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego (UCSD). At its inception, the clinic sought to answer two questions. First, would 60-minute visits with a pharmacist who provided medication therapy management and tailored diabetes education help patients manage their diabetes better? Second, would the patients come away from the clinic with skills they could use for the rest of their lives in primary care settings? I was hoping that if we spent more time with each patient in a less rushed visit, it would meet two goals: Help patients to achieve and sustain diabetes control while lowering costs for the medical center, said Morello. Those were lofty goals considering that patients would only have three or four visits in a span Continue reading >>

Detail-document: Pharmacist's Letter

Detail-document: Pharmacist's Letter

There are lots of medications available and many ways to start therapy. The guidelines use a variety of A1C cutoffs for treatment recommendations, such as when to initiate insulin or consider dual therapy.1-3 Ultimately, medication selection should be based on the patients clinical presentation, blood glucose levels or A1C, and patient specific factors (e.g., concomitant conditions, renal function, etc). Consider using these strategies to initiate therapy for any patient with new-onset type 2 diabetes, even those presenting with a very high blood glucose level (e.g., >350 mg/dL [~20 mmol/L]). Assess patient stability and need for urgent treatment. Administer sodium bicarbonate to maintain a pH 7.8,9 Project Leader in preparation of this professional resource: Beth Bryant, Pharm.D., BCPS, Assistant Editor Cefalu W, Bakris G, Blonde L, et al. American Diabetes Association standards of medical care in diabetes 2016. Diabetes Care 2016;39:S1-112. Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm 2016 executive summary. Endocr Pract 2016;22:84-113 . Canadian Diabetes Association. Pharmacologic management of type 2 diabetes: 2016 interim update. . (Accessed September 2, 2016). Amblee A, Lious D, Fogelfeld L. Combination of saxaglipitin and metformin is effective as initial therapy in new-onset type 2 diabetes mellitus with severe hyperglycemia. J Clin Endocrinol Metab 2016:101:2528-35 . Cahn A, Cefalu WT. Clinical considerations for use of initial combination therapy in type 2 diabetes. Diabetes Care 2016;39:s137-45 . Henske JA, Griffith ML, Fowler MJ. Initiating and titrating insulin in patients with type 2 Continue reading >>

Metabolic Control And Adherence To American Diabetes Association Practice Guidelines In A Pharmacist-managed Diabetes Clinic

Metabolic Control And Adherence To American Diabetes Association Practice Guidelines In A Pharmacist-managed Diabetes Clinic

Metabolic Control and Adherence to American Diabetes Association Practice Guidelines in a Pharmacist-Managed Diabetes Clinic 1Department of Pharmacy Practice, Wayne State University, Detroit, Michigan 2Clinical Pharmacist Consultant, San Diego, California 3Department of Internal Medicine, Wayne State University School of Medicine and the Detroit Medical Center, Detroit, Michigan 4Detroit Medical Center Physician Group, Wayne State University and the Detroit Medical Center, Detroit, Michigan Diabetes Care 2002 Aug; 25(8): 1479-1479. The provision of diabetes care has shifted from the specialist to the generalist in primary care practice. Evidence suggests utilization of nonphysician providers in conjunction with physician-directed protocols improves glycemic control ( 1 ). The purpose of this study was to evaluate the impact of a pharmacist-managed diabetes clinic (PMC) on glycemic control and adherence to American Diabetes Association (ADA) standards of medical care in a collaborative physician-pharmacist practice. This was a retrospective analysis comparing patients referred to the PMC for diabetes management with a randomly selected group of patients with diabetes, managed exclusively by their primary care physicians. Only patients with a minimum of 3 months of laboratory data and two visits to the pharmacist or physicians were included. Pharmacist-managed clinic patients (16 women, 12 men) were 51.8 14.7 years of age and had a BMI of 35.4 9.2 kg/m2 (mean SD). The physician-managed group (16 women, 13 men) were 56.4 13.8 years of age and had a BMI of 33.5 9.2 kg/m2. Over 90% of patients in each group were African-American and had type 2 diabetes. Average duration of diabetes was not significantly different between groups. Baseline HbA1c values were significantly high Continue reading >>

Managing Gestational Diabetes: The Clinical Pharmacists Role In A Patient-centered Medical Home Model

Managing Gestational Diabetes: The Clinical Pharmacists Role In A Patient-centered Medical Home Model

Managing Gestational Diabetes: The Clinical Pharmacists Role in a Patient-Centered Medical Home Model UTEP/UT Austin Cooperative Pharmacy Program ABSTRACT: Clinical pharmacists can play a vital role on a multidisciplinary team and assist with the management of patients with gestational diabetes. In this innovative practice model, implemented in a community health center working toward the designation of a patient-centered medical home, pharmacists collaborate with womens health providers to educate patients and manage gestational diabetes. Pharmacists have the opportunity to contribute medication expertise in making pharmacotherapeutic decisions. By collaborating with the clinicians providing obstetric care, pharmacists can offer education on lifestyle modifications, self-monitoring of blood glucose, and drug therapy. Gestational diabetes mellitus (GDM) is defined as diabetes that first presents during pregnancy.1 It is estimated that the national prevalence of GDM ranges from 2% to 10%.2 However, in states such as Texas the rates have been steadily increasing over the past few years. Data from the Pregnancy and Risk Assessment Monitoring System (PRAMS) for Texas have shown that from 2004 to 2009, the prevalence of gestational diabetes increased from 9.2% to 11.5%.3 This article will review the risk factors for and diagnosis of GDM, discuss the challenges inherent in caring for women with this condition, and describe the experience of the authors in a community health center in Texas that is initiating a team approach to caring for women with GDM in a patient-centered medical home, a process that is still evolving. Risk factors for gestational diabetes include age, ethnic group, a history of deliveries with complications, and a history of glucose intolerance.4 Women at Continue reading >>

Pharm-md; An Open-label, Randomized Controlled, Phase Ii Study To Evaluate The Efficacy Of A Pharmacist-managed Diabetes Clinic In High-risk Diabetes Patients Study Protocol For A Randomized Controlled Trial

Pharm-md; An Open-label, Randomized Controlled, Phase Ii Study To Evaluate The Efficacy Of A Pharmacist-managed Diabetes Clinic In High-risk Diabetes Patients Study Protocol For A Randomized Controlled Trial

Pharm-MD; an open-label, randomized controlled, phase II study to evaluate the efficacy of a pharmacist-managed diabetes clinic in high-risk diabetes patients study protocol for a randomized controlled trial Millions of Americans are currently living with diabetes and approximately 1.5 million cases are being diagnosed each year. Diabetes is now the seventh leading cause of death in the United States. In addition, the economic burden of the disease has resulted in billions of dollars in health care costs. In spite of these investments, the United States lags behind other developed countries on diabetes life expectancy and disease-related deaths. The purpose of this study is to assess the impact of a pharmacist-managed diabetes clinic (PMDC) model on diabetes core measures. Our hypothesis is that a PMDC would have a significant positive impact on the diabetes measures and will result in higher-quality care at a lower price. This study is a randomized, open-label, controlled, parallel-group trial which will be conducted in the outpatient clinic at Beaumont Hospital, Royal Oak, Michigan. Patients will be randomly assigned to one of two groups: standard of care (SOC) or standard of care plus PMDC (SOC + PMDC). Included in the study will be patients older than 18years of age with a diagnosis of type 2 diabetes mellitus and a hemoglobin A1c 9%, who are established with a primary care resident and who have not been seen in the PMDC within the last 3months. The primary outcome is the change in hemoglobin A1c, measured at 6 and 12months. Secondary outcomes include the impact on all diabetes core measures, patient quality of life, harms, and cost impact related to the intervention. If the results of this trial are consistent with the previous retrospective analysis that a pharma Continue reading >>

Pharmacist-led Clinic Helps Improve Diabetes Outcomes

Pharmacist-led Clinic Helps Improve Diabetes Outcomes

Pharmacist-led clinic helps improve diabetes outcomes Key clinical point: A 6-month pharmacist-led diabetes clinic lowered HbA1c levels and reduced estimated costs. Major finding: HbA1c levels fell by 2.4% in the intervention group and 0.2% in the comparison group. Data source: A retrospective comparison of data on 85 patients in the intervention group and 51 patients seen in primary care clinics. Disclosures: Dr. Morello reported having no financial disclosures. SAN FRANCISCO Hemoglobin A1c levels fell by 2.4% in veterans with diabetes whose primary care physicians referred them to a 6-month pharmacist-led intense management clinic, compared with a 0.2% drop in similar patients who did not attend the clinic. That translates to a $9,104 reduction in estimated 3-year medical costs for each patient seen in the clinic and a $1,803 drop in costs in the comparison group, reported Candis M. Morello, Pharm.D. The changes in HbA1c and costs in the intervention group were significant, compared with the nonclinic group. After factoring in the $61,992 cost of the pharmacist over 3 years, $7.81 would be saved for every $1 spent on the program , said Dr. Morello of the University of California, San Diego, and director of the diabetes intense medical management clinic in the Veterans Affairs San Diego Healthcare System. The clinic is a collaborative practice between an endocrinologist and a doctor of pharmacy who also is a certified diabetes educator and has full prescribing privileges. The pharmacist spends 4 hours/week in the clinic and 3 hours/week on phone follow-up calls to manage 60 patients per year who have HbA1c levels of at least 8%, high comorbidity, and complex medication regimens. Patients are referred by primary care providers for the 6-month "tune-up" clinic involving Continue reading >>

Program Site Descriptions

Program Site Descriptions

Ardsley Internal Medicine is composed of Internal Medicine providers (Internists) who specialize in the prevention, diagnoses, and treatment of acute and chronic illnesses that affect adults. Ardsley Internal Medicine is a multi-site practice. The Concord location is within two miles of Carolinas HealthCare System NorthEast in Concord, NC. The second practice site is located in Harrisburg, a growing suburb of Charlotte. Providers at the clinics include physicians, a nurse practitioner, and pharmacists. Patients are referred by their primary care providers to pharmacist-led clinics that specialize in medication management in the areas of anticoagulation, diabetes mellitus, polypharmacy, and weight loss management. Pharmacists assess patients during clinic visits, review pertinent laboratory data, perform point-of-care testing, determine appropriate therapy, and initiate therapeutic plans. Two expanding areas of practice for the clinical pharmacists are Continuous Glucose Monitoring (CGM)and performing Medicare Annual Wellness Visits (AWVs). The pharmacists at the Harrisburg location are already doing Medicare Annual Wellness Visits for the site. This will be coming in 2017 for the pharmacists at the Concord location. Ardsley is also a teaching and rotation site for 4th year pharmacy students from the UNC Eshelman School of Pharmacy and Wingate University School of Pharmacy. Pharmacists also serve as drug information providers to the medical staff and patients. This includes providing information on medication dosing, drug interactions, product availability, prescription assistance programs, and affordable medication alternatives, to name a few. Located inside Carolinas HealthCare System NorthEast, Concord Internal Medicine is composed of practicing physician assistants, Continue reading >>

Provision Of Medication Therapy Management By Pharmacists To Patients With Type-2 Diabetes Mellitus In A Federally Qualified Health Center

Provision Of Medication Therapy Management By Pharmacists To Patients With Type-2 Diabetes Mellitus In A Federally Qualified Health Center

Type-2 diabetes mellitus is a chronic condition that may have serious implications for a persons health if not managed properly. Sustained elevated blood glucose levels can lead to complications such as nephropathy, neuropathy, retinopathy, and most importantly, atherosclerotic cardiovascular disease. 1 3 According to the Centers for Disease Control and Prevention, more than 29 million people have diabetes in the United States, with one out of every four being undiagnosed. 4 5 Lowering hemoglobin A1c (HbA1c) to less than 7% has been shown to reduce microvascular and macrovascular complications. 2 Table 1 shows the benefits of diabetes control based on HbA1c reduction. Type-2 diabetes is a complex condition that requires treatment with a combination of modalities, including lifestyle modifications, medical nutrition therapy, oral antihyperglycemic agents, noninsulin injectable agents, and insulin. Several studies have provided evidence of the value to and improvement of patient outcomes in diabetes care through provision of medication therapy management (MTM) services by pharmacists. A meta-analysis of 44 studies was conducted in 2014 to assess the effectiveness of interventions made as a result of MTM services in patients with chronic conditions; the analysis showed that MTM improved appropriate medication prescribing, use, and adherence. 6 The long-term clinical and economic benefits described by The Asheville Project investigators include more than 50% of patients presenting with decreased HbA1c in addition to an increased number of patients with optimal HbA1c values of less than 7% at each follow-up assessment. 7 Clinical pharmacists efforts to work with patients to achieve positive quality outcome measures in diabetes management have also been well studied. Joseph Continue reading >>

More in diabetes