Department of Clinical and Administrative Sciences, University of Louisiana at Monroe, USA.
J Am Pharm Assoc (2003). 2012;52(6):e266-72. doi: 10.1331/JAPhA.2012.11225.
To describe an insulin titration-by-phone service conducted by pharmacists and to discuss the effects of this service on patient care and outcomes in the first year of its existence.
An academic family medicine department in which pharmacists practice in nondistributory roles, from March 2009 through March 2010.
Pharmacy services within the department include a chronic disease medication therapy management clinic as well as consultation in various other primary care and specialty clinics. Fourth-year student pharmacists complete advanced pharmacy practice experiences at this site as well.
Based upon a need identified by department providers (physicians and physician assistants), an insulin titration-by-phone service was implemented by two faculty pharmacists. Patients were referred into this service by their primary care provider (PCP) and were called by one of the pharmacists on a regular basis. Pharmacist recommendations for insulin dose adjustments were made based on patient reported self-monitored glucose values. PCP approved recommendations and the patient was notified of changes.
Decrease in glycosylated hemoglobin (A1C ) within 9 months of referral to the service when compared with baseline.
Analysis included 76 patients. The mean decrease in A1C was 1.55% (SD 2.31; P <0.001). The largest decrease in A1C (1.4%) was seen in the first 3 months after referral. Seven patients achieved an A1C ≤7% ( P = 0.007). Forty-one patients had a decrease in A1C of at least 1% during the first 9 months after their referral ( P <0.001).
The implementation of a pharmacist-run insulin titration-by-phone service resulted in improvements in A1C that were most pronounced in the first 3 months after referral.
描述药剂师通过电话进行胰岛素滴定的服务，并讨论该服务在存在的第一年对患者护理和结果的影响。
药剂师以非配药角色在 2009 年 3 月至 2010 年 3 月期间在一个学术家庭医学系中开展实践。
该部门的药房服务包括慢性病药物治疗管理诊所以及在各种其他初级保健和专科诊所的咨询。第四年的实习药剂师也在该地点完成高级药房实践经验。
根据部门提供者（医生和医师助理）确定的需求，两名药学教师实施了胰岛素电话滴定服务。患者由他们的初级保健提供者（PCP）转介到该服务中，并由其中一位药剂师定期打电话。药剂师根据患者报告的自我监测血糖值建议胰岛素剂量调整。PCP 批准建议并通知患者变更。
与基线相比，转介至服务后 9 个月内糖化血红蛋白（A1C）的下降。
分析包括 76 名患者。A1C 的平均下降率为 1.55%（SD 2.31；P<0.001）。转介后 3 个月内 A1C 下降最大（1.4%）。7 名患者的 A1C 达到≤7%（P=0.007）。41 名患者在转介后的头 9 个月内 A1C 至少下降了 1%（P<0.001）。
实施由药剂师管理的胰岛素电话滴定服务可改善 A1C，转介后 3 个月内最为明显。
