Rodriguez de Bittner Magaly, Chirikov Viktor V, Breunig Ian M, Zaghab Roxanne W, Shaya Fadia Tohme
J Am Pharm Assoc (2003). 2017 Jan-Feb;57(1):102-108.e4. doi: 10.1016/j.japh.2016.08.010. Epub 2016 Oct 18.
To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period.
The Patients, Pharmacists Partnerships (P Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites.
Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2.5 years per patient. Of these patients, 162 had health plan cost and utilization data. A network of 50 trained pharmacists provided chronic disease management to patients with diabetes using a common process of care. Communications were provided to patients and physicians.
Employers provided incentives for patients who opted in, including waived medication copayments and free diabetes self-monitoring supplies. The service was provided at no cost to the patient. A Web-based, electronic medical record that complied with the Health Insurance Portability and Accountability Act helped to standardize care. Quality assurance was conducted to ensure the standard of care.
Glycosylated hemoglobin (A1c), blood pressure, and total health care costs (before and after enrollment).
Statistically significant improvements were shown by mean decreases in A1c (-0.41%, P <0.001), low-density lipoprotein levels (-4.7 mg/dL, P = 0.003), systolic blood pressure (-2.3 mm Hg, P = 0.001), and diastolic blood pressure (-2.4 mm Hg, P <0.001). Total annual health care costs to employers declined by $1031 per beneficiary after the cost of the program was deducted. This 66-month real-world study confirms earlier findings. Employers netted savings through improved clinical outcomes and reduced emergency and hospital utilization when comparing costs 12 months before and after enrollment.
The P program had positive clinical outcomes and economic outcomes. Pharmacist-provided comprehensive medication therapy management services should be included as a required element of insurance offered by employers and health insurance exchanges.
确定在5年期间，为患有糖尿病的在职患者群体提供的一项真实世界、持续的、由药剂师提供的服务的有效性和成本节约情况。
“患者 - 药剂师伙伴关系”（P项目）作为一项“选择加入”福利，提供给马里兰州和弗吉尼亚州6家公共和私人自保雇主的员工。在邮政编码匹配的地点以及2家雇主的工作场所提供护理服务。
2006年7月至2012年5月期间，对602名登记的1型和2型糖尿病患者进行了研究，每位患者的平均随访时间为2.5年。其中162名患者有健康计划成本和使用数据。由50名经过培训的药剂师组成的网络，使用通用的护理流程为糖尿病患者提供慢性病管理。向患者和医生提供沟通服务。
雇主为选择加入的患者提供激励措施，包括免除药物自付费用和免费提供糖尿病自我监测用品。该服务对患者免费提供。一个符合《健康保险流通与责任法案》的基于网络的电子病历有助于规范护理。进行质量保证以确保护理标准。
糖化血红蛋白（A1c）、血压和总医疗保健成本（登记前后）。
A1c平均下降（-0.41%，P<0.001）、低密度脂蛋白水平下降（-4.7mg/dL，P = 0.003）、收缩压下降（-2.3mmHg，P = 0.001）和舒张压下降（-2.4mmHg，P<0.001），显示出具有统计学意义的改善。扣除项目成本后，雇主的每位受益人的年度总医疗保健成本下降了1031美元。这项为期66个月的真实世界研究证实了早期研究结果。与登记前12个月和登记后12个月的成本相比，雇主通过改善临床结果以及减少急诊和住院使用而实现了净节约。
P项目具有积极的临床结果和经济结果。由药剂师提供的全面药物治疗管理服务应作为雇主和健康保险交易所提供的保险的必要组成部分。
