Community pharmacist collaboration with a primary care clinic to improve diabetes care.

OBJECTIVE

The objective of this pilot project was to evaluate a model of care that consisted of a community pharmacist and registered nurse collaborating in a primary care clinic to improve guideline-directed therapy.

SETTING

A regional grocery chain pharmacy partnered with a primary care clinic associated with a large academic medical center.

PRACTICE INNOVATION

A community pharmacist was granted access to the electronic medical record and paired with a registered nurse care manager at a primary care office.

EVALUATION

Forty-one patients were included and assessed for diabetes guidelines directed care. The pharmacist completed chart reviews and sent recommendations to a registered nurse care manager and the patient's primary care provider. The nurse facilitated lab orders, discussed the pharmacist's recommendations, and scheduled appointments as necessary for the patient.

RESULTS

This intervention resulted in initial improvement in glycemic control followed by a decline at 3 months. Surrogate markers for prevention of micro- and macrovascular complications improved at 3 months. Optimization of medications for glycemic control and complication prevention also improved.

CONCLUSION

The collaboration between a community pharmacist and primary care clinic led to improved adherence to guideline-directed diabetes care. Access to electronic medical records was necessary for pharmacist recommendations and communication. Pharmacist involvement in clinical recommendations at a primary care clinic in addition to standard duties at a community pharmacy may further improve care for patients with diabetes and requires further evaluation.