The Asheville Project: Short-term outcomes of a community pharmacy diabetes care program |
| |
| Authors: | Carole W. Cranor Dale B. Christensen |
| |
| Affiliation: | 1. Departamento de Farmacología Clínica, Facultad de Medicina, Universidad de La Sabana, Chía, Colombia;2. Departamento de Investigación, Facultad de Medicina, Universidad de La Sabana, Chía, Colombia;3. Departamento de Farmacología Clínica y Terapéutica, Clínica Universidad de La Sabana, Chía, Colombia;4. Subdirección de Docencia e Investigación, Hospital Militar Central, Bogotá, Colombia;5. Servicio Farmacología Clínica, Clínicos IPS, Bogotá, Colombia;6. Unidad de Reumatología, Hospital Universitario San Ignacio – Pontificia Universidad Javeriana, Bogotá, Colombia;7. Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Sabana, Chía, Colombia;1. Division of Rheumatology, Department of Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA;2. Department of Health Sciences Research, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA;1. Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States;2. Transplant Institute, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, United States;3. UNC Eshelman School of Pharmacy, 300 Pharmacy Lane, Chapel Hill, NC 27599, United States;1. Indiana University School of Medicine, Purdue University, West Lafayette, IN 47907, USA;2. Purdue University College of Pharmacy, West Lafayette, IN 47907, USA;3. Experiential Education, Purdue University College of Pharmacy, USA |
| |
| Abstract: | Objectives:To assess short-term clinical, economic, and humanistic outcomes of pharmaceutical care services (PCS) for patients with diabetes in community pharmaciesDesign:Intention-to-treat, pre–post cohort-with-comparison group study.Setting:Twelve community pharmacies in Asheville, N.C.Patients and Other Participants:Eighty-five patients with diabetes who were employees, dependents, or retirees from two self-insured employers; community pharmacists who completed a diabetes certificate program and received reimbursement for PCS.Interventions:Patients scheduled consultations with pharmacists over 7 to 9 months. Pharmacists provided education, self-monitored blood glucose (SMBG) meter training, clinical assessment, patient monitoring, follow-up, and referral. Group 1 patients began receiving PCS in March 1997, and group 2 patients began in March 1999.Main Outcome Measures:Change from baseline in the two employer groups in glycosylated hemoglobin (A1c) values, serum lipid concentrations, health-related quality of life (HRQOL), satisfaction with pharmacy services, and health care utilization and costs.Results:Patients used SMBG meters at home, stored all readings, and brought their meters with them to 87% of the 317 PCS visits (3.7 visits per patient). Patients‘ A1c concentrations were significantly reduced, and their satisfaction with pharmacy services improved significantly. Patients experienced no change in HRQOL. From the payers’ perspective, there was a significant $52 per patient per month increase in diabetes costs for both groups, with PCS fees and diabetes prescriptions accounting for most of the increase. In contrast, both groups experienced a nonsignificant but economically important 29% decrease in nondiabetes costs and a 16% decrease in all-diagnosis costs.Conclusion:A clear temporal relationship was found between PCS and improved A1c, improved patient satisfaction with pharmacy services, and decreased all-diagnosis costs. Findings from this study demonstrate that pharmacists provided effective cognitive services and refute the idea that pharmacists must be certified diabetes educators to help patients with diabetes improve clinical outcomes. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
