Journal of the American Pharmacists Association : JAPhA · 2015
Pharmacist-provided diabetes management and education via a telemonitoring program.
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Shane-McWhorter Laura, McAdam-Marx Carrie, Lenert Leslie, Petersen Marta, Woolsey Sarah, Coursey Jeffrey M, Whittaker Thomas C, Hyer Christian, LaMarche Deb, Carroll Patricia, Chuy Libbey
Аннотация
OBJECTIVE: To assess clinical outcomes (glycosylated hemoglobin [A1C], blood pressure, and lipids) and other measurements (disease state knowledge, adherence, and self-efficacy) associated with the use of approved telemonitoring devices to expand and improve chronic disease management of patients with diabetes, with or without hypertension.
SETTING: Four community health centers (CHCs) in Utah.
PRACTICE DESCRIPTION: Federally qualified safety net clinics that provide medical care to underserved patients.
PRACTICE INNOVATION: Pharmacist-led diabetes management using telemonitoring was compared with a group of patients receiving usual care (without telemonitoring).
INTERVENTIONS: Daily blood glucose (BG) and blood pressure (BP) values were reviewed and the pharmacist provided phone follow-up to assess and manage out-of-range BG and BP values.
EVALUATION: Changes in A1C, BP, and low-density lipoprotein (LDL) at approximately 6 months were compared between the telemonitoring group and the usual care group. Patient activation, diabetes/hypertension knowledge, and medication adherence were measured in the telemonitoring group.
RESULTS: Of 150 patients, 75 received pharmacist-provided diabetes management and education via telemonitoring, and 75 received usual medical care. Change in A1C was significantly greater in the telemonitoring group compared with the usual care group (2.07% decrease vs. 0.66% decrease; P <0.001). Although BP and LDL levels also declined, differences between the two groups were not statistically significant. Patient activation measure, diabetes/hypertension knowledge, and medication adherence with antihypertensives (but not diabetes medications) improved in the telemonitoring group.
CONCLUSION: Pharmacist-provided diabetes management via telemonitoring resulted in a significant improvement in A1C in federally qualified CHCs in Utah compared with usual medical care. Telemonitoring may be considered a model for providing clinical pharmacy services to patients with diabetes.
SETTING: Four community health centers (CHCs) in Utah.
PRACTICE DESCRIPTION: Federally qualified safety net clinics that provide medical care to underserved patients.
PRACTICE INNOVATION: Pharmacist-led diabetes management using telemonitoring was compared with a group of patients receiving usual care (without telemonitoring).
INTERVENTIONS: Daily blood glucose (BG) and blood pressure (BP) values were reviewed and the pharmacist provided phone follow-up to assess and manage out-of-range BG and BP values.
EVALUATION: Changes in A1C, BP, and low-density lipoprotein (LDL) at approximately 6 months were compared between the telemonitoring group and the usual care group. Patient activation, diabetes/hypertension knowledge, and medication adherence were measured in the telemonitoring group.
RESULTS: Of 150 patients, 75 received pharmacist-provided diabetes management and education via telemonitoring, and 75 received usual medical care. Change in A1C was significantly greater in the telemonitoring group compared with the usual care group (2.07% decrease vs. 0.66% decrease; P <0.001). Although BP and LDL levels also declined, differences between the two groups were not statistically significant. Patient activation measure, diabetes/hypertension knowledge, and medication adherence with antihypertensives (but not diabetes medications) improved in the telemonitoring group.
CONCLUSION: Pharmacist-provided diabetes management via telemonitoring resulted in a significant improvement in A1C in federally qualified CHCs in Utah compared with usual medical care. Telemonitoring may be considered a model for providing clinical pharmacy services to patients with diabetes.