B. DeeAnn Dugan, Roger D. Lander, Jessica Skelley, Bryn Manzella
ABSTRACT
Objectives: Diabetes affects 29.1 million Americans. The relationship between poor health literacy, lower socioeconomic status, the psychosocial barriers related to diabetes is well established. With the association between glycemic control and diabetes complications, the importance of patient education/management to improve self-efficacy and glucose control is compelling. Several studies have demonstrated the impact of pharmacist-led diabetes education/management services in self-insured employer groups; however little has been published with patients facing access, income, and health literacy challenges. Study objective: To evaluate the impact of a pharmacist-led diabetes clinic in a public health department population.
Methods: Public health department patients with diabetes and hemoglobin A1c (A1C) ≥ 9% were identified by electronic medical record query or referral. Intervention group patients were enrolled in the pharmacist-led diabetes clinic while patients of other health centers were managed by usual care. Primary endpoint was change in A1C from baseline to study end for the intervention group.
Results: Ninety-four patients, primarily African American women age of 49.5 years, were included in the study. There were no significant differences between the groups regarding baseline characteristics; although the intervention group had a higher A1C at baseline (11.3% vs 10.8%) than the usual care group. At the end of the study, the intervention group had an A1C reduction of 2% (p< 0.0002) whereas the usual care group achieved a 0.8% (p= 0.16) reduction over the same time period.
Conclusions: A pharmacist-led diabetes service is effective in enabling public health department patients to significantly reduce their average blood glucose level.