Community pharmacy Target Intervention Program to improve aspirin use in persons with diabetes.

OBJECTIVE

To identify the rate of aspirin or antiplatelet/anticoagulant use in persons with diabetes presenting to community pharmacies and determine whether a student pharmacist-driven Target Intervention Program (TIP) could increase the number of eligible persons with diabetes receiving aspirin therapy in accordance with American Diabetes Association (ADA) recommendations.

DESIGN

Unblinded, single intervention.

SETTING

Eight Community Pharmacy Advanced Practice Experience (CPAPE) sites in New York State.

PARTICIPANTS

Persons having prescriptions filled for diabetes medications or supplies who were not receiving antiplatelet/anticoagulant medications.

INTERVENTIONS

Assessment sheets were completed by student pharmacists for eligible patients to determine appropriateness for aspirin therapy. Recommendations for aspirin therapy were faxed to physicians when indicated, and physicians responded via fax for aspirin therapy implementation. The student pharmacists contacted patients, informed patients of physician decisions, and provided appropriate counseling.

MAIN OUTCOME MEASURES

Number of persons with diabetes currently receiving aspirin or antiplatelet/anticoagulant medications and the number initiated on aspirin as a result of the TIP.

RESULTS

A total of 436 persons with diabetes were identified. Of those contacted, 322 agreed to participate and 31 declined; 228 were taking aspirin or other antiplatelet/anticoagulant agents at baseline. Students completed assessment sheets, which were forwarded to physicians, for 79 subjects potentially eligible to receive aspirin therapy; 65 physician responses were received (82% response rate). Aspirin therapy was initiated in 53 patients (67%).

CONCLUSION

The TIP enabled CPAPE students to increase aspirin use among eligible persons with diabetes in accordance with ADA guidelines.