Outcomes from DiabetesCARE: a pharmacist-provided diabetes management service.

OBJECTIVE

To describe outcomes attained by the DiabetesCARE component of the PharmacistCARE program, which is an innovative pharmacy practice model implemented within a self-insured employer.

DESIGN

Descriptive nonexperimental study.

SETTING

University of Kentucky (UK), from March 2003 through December 2006.

PATIENTS

236 patients with diabetes (95% with type 2 diabetes).

INTERVENTION

Three clinical pharmacists provided UK Health Plan (UKHP) members with diabetes with comprehensive disease state and medication therapy management.

MAIN OUTCOME MEASURES

Clinical outcomes included glycosylated hemoglobin (A1C), fasting lipid panels, blood pressure, weight, vaccination rates, and aspirin use. Humanistic outcomes included the mental and physical components of the 12-Item Short-Form Health Survey (SF-12) and patient satisfaction with health services related to their diabetes care. Screening parameters included the proportion of patients meeting Healthcare Effectiveness Data and Information Set expectations for patients with diabetes. Productivity and health resource use were also assessed based on patient responses to survey questions.

RESULTS

After 1 year of enrollment, patients in the DiabetesCARE program achieved improved clinical outcomes compared with baseline, as evidenced by statistically significant reductions in A1C, low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Statistically significant increases were seen in high-density lipoprotein cholesterol and the proportion of patients obtaining influenza vaccine, yearly screenings for lipid level assessment, screenings for kidney disease, and eye examinations. The mental component score of the SF-12 was significantly increased. Patients were highly satisfied with the DiabetesCARE service, and satisfaction with their overall diabetes care within UKHP was significantly enhanced. Based on the patient provided survey data analyzed here, productivity and health resource use were unchanged; however, additional analyses using UKHP claims data are ongoing.

CONCLUSION

The DiabetesCARE program is a unique pharmacist-provided service delivered in a freestanding pharmacist clinic that enhances health outcomes for adult members with diabetes in a self-insured employer group.