Short-term outcomes of an employer-sponsored diabetes management program at an ambulatory care pharmacy clinic

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Abstract

Purpose

The impact of a collaborative, employer-sponsored diabetes management program on glycemic control and other clinical endpoints over 6–12 months is reported.

Methods

In a retrospective, chart-based evaluation, glycosylated hemoglobin (HbA1c) and related health status indicators were assessed among first-year enrollees in the Healthy Outcome Partnership for Employees (HOPE) with Diabetes Program, an ongoing program sponsored by the Wake Forest Baptist Health (WFBH) system. Diabetes management services were provided by pharmacists in collaboration with providers inside and outside the WFBH system. The primary endpoint was the mean change in HbA1c during follow-up averaging 8.2 months; secondary endpoints included changes in blood pressure, cholesterol, and triglyceride levels.

Results

Among the 98 patients included in the data analysis (75.5% women, 72.4% Caucasian), the mean HbA1c value decreased significantly during the study period (from 7.8% to 7.1%, p < 0.01); the proportion of patients at the recommended goal of an HbA1c of ≤7.0% rose from 40.8% to 56.1% (p < 0.01). HOPE Program enrollees also experienced significant improvements in mean triglyceride, total cholesterol, and blood pressure values (p < 0.05 for all). A subgroup of patients with initially poor glycemic control (HbA1c of ≥8.0%) had a mean HbA1c reduction of 1.7 percentage points during the study (p < 0.01), suggesting that the greatest benefits occurred in the highest-risk patients.

Conclusion

Among patients seen for at least six months at an employer-sponsored ambulatory care diabetes clinic managed by pharmacists, significant improvements from baseline in clinical end-points including HbA1c and blood pressure were demonstrated.

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