2018 Research Forum

Clinical outcomes of pharmacist-led diabetes clinic Presenter: Rajinder Kaur PharmD Faculty Sponsor: Jeff Jolliff PharmD BCPS BCACP AAHIVP CDE Rajinder Kaur PharmD 1 , David Lash PharmD MPH CDE 2 , Jeff Jolliff PharmD BCPS BCACP AAHIVP CDE 3 1 Pharmacy Resident R1 2 Clinical Pharmacist 3 Clinical Pharmacy Residency Program Director; Adjunct Professor of Pharmacy Practice, University of the Pacific INTRODUCTION Diabetes mellitus is associated with substantial morbidity and mortality. Diabetes affects an estimated 30.3 million people in the US, 7.2 million of those being undiagnosed. Diabetes mellitus causes a significant economic burden when left untreated. Healthcare effectiveness data and information set (HEDIS®) is a standardized set of performance measurements developed by the National Committee for Quality Assurance (NCQA) to ensure that comprehensive diabetes care is delivered. PURPOSE The objective of this study is to evaluate the effect of pharmacist-led diabetes clinic enrollment on patients with uncontrolled diabetes. METHOD This retrospective study evaluates outcomes for patients referred to a clinical pharmacist for management of diabetes. Data collected included adults between 18 and 75 with the diagnosis of type 1 or type 2 diabetes mellitus during the period of January 2012 through March 2018. The primary outcome will assess mean change in hemoglobin A1c (A1c) and glycemic control in terms of mean change in A1c and proportion of patients who attain HEDIS goal A1c of <8.0%. Secondary outcomes evaluate change in BMI, maintaining blood pressure <140/80, routine foot exams and routine eye exams. Exclusion criteria includes initial A1C<7%, change in service to high risk Reach/Grow clinic, non- compliance with visits, and pregnancy. RESULTS A total of 264 patients were screened between the periods of January 2012 through March 2018, 111 patients were excluded. The mean A1c at entry was 10.02 +/- 1.99% and the mean A1c at the end was 8.23 +/- 1.61 % which reflects a mean reduction in A1C of 1.8%(p<0.001). The HEDIS goal of A1c <8% was achieved in 50.3% of the studied population post enrollment. The mean change in BMI was 0.38 kg/m2. In the study population a foot exam was completed within the last year in 73 % of the study population. Additionally, an eye exam was completed within the last year for 43% of the population. Entry End P-Value Mean A1c 10.02 (1.99) 8.23 (1.61) P<0.001 HbA1c poor control >9% (n) 62.09% (95) 28.80% (44) P<0.0001 HbA1c controlled <8% (n) 16.3% (25) 50.3% (77) P<0.0001 Blood Pressure <140/90 mmHg 55% (85) 70% (108) P=0.0049 BMI in kg/m 2 33.72(7.79) 33.34 (7.52) P=0.7068 Eye Exam 43% (65) Foot Exam 73% (93)

4