Author/Authors :
Chong, Mok Thoong Department of Clinical and Administrative Sciences - American University of Health Sciences, California, USA
Abstract :
: The objective of this study was to evaluate the impact of pharmacist’s
interventions through a collaborative ambulatory care pharmacy practice (CAPP)
model in patients with type 2 diabetes mellitus (T2DM) among the underrepresented
population. Methods: Eligible patients were 18 years and older with a diagnosis of
T2DM with or without comorbid cardiovascular disease risk factors. Patients were
enrolled through routine primary care provider referrals. During a one‑on‑one,
face‑to‑face scheduled clinic visit, the pharmacist provided a comprehensive
medication management by reviewing vital signs and laboratory values, provided
medication reconciliation and management, followed by medication counseling
through a CAPP approach in a primary care setting. The pharmacist worked in
close collaboration with the primary care provider to intervene on medication
therapy through recommendations to initiate, adjust, modify, or discontinue drug
therapy and order laboratory tests and drug concentration levels as appropriate.
Each visit was documented as a “PharmD Progress Note” in the patient’s electronic
medical record. Follow‑up visits were scheduled until patients’ targeted treatment
goals were achieved. Primary and secondary outcome data were collected and
then analyzed. Findings: A pharmacist saw 47 patients over 12 months. Sixty‑four
percent of the participating patients were able to achieve targeted treatment goals.
A statistically significant decrease in the mean change in hemoglobin A1c, diastolic
blood pressure, fasting blood glucose, and triglyceride levels was observed from
the baseline which was −2.3%, −7.75 mmHg, −76.1 mg/dL, and −55.5 mg/dL,
respectively. No significant changes in other clinical outcomes were observed.
Conclusion: The CAPP model demonstrated a significant reduction in clinical
endpoints in patients with T2DM among the high‑risk underrepresented population.
Keywords :
Ambulatory care , clinical outcomes , collaborative ambulatory care pharmacy practice , diabetes mellitus , medication adherence