Pontefract Benjamin A, King Benjamin S, Gothard David M, King Cynthia A
MetroHealth Medical Center, Cleveland, Ohio.
Biostats Inc., East Canton, Ohio.
Innov Pharm. 2018 Aug 10;9(2):1-8. doi: 10.24926/iip.v9i2.985. eCollection 2018.
Current literature supports pharmacists effectively lower hemoglobin A1c (HbA1c) in diabetic patients. Little data exists on pharmacists' effects on comorbidity management, patient satisfaction, or the financial viability of these positions. This study looked to assess the impact of pharmacists on diabetes management compared to usual care.
This multi-site, two-part study includes a retrospective chart review of patients referred to the pharmacist versus usual care within a large academic health system. The pharmacists collaborated under a consult agreement with primary care physicians. The second part of the study assessed patient satisfaction through an abbreviated CG-CAHPS survey.
A total of 206 patients with diabetes for an average of 12 years were included. The average patient age was 62 years with 60% of patients identifying as female and 81% as African-American. Patients were enrolled in a 2:1 fashion with 138 patients in the pharmacist-management group. Average baseline HbA1c was 10.1% in the pharmacist-management group and 9.3% in the usual care group (p= 0.0125). At 6 months, the mean change in HbA1c was -2.17% and 0.48% for the intervention and control groups respectively (p < 0.001).
Pharmacists are effective at lowering HbA1c in primary care clinics, and patients were highly satisfied with these services. While direct revenue from this service did not meet cost, the pharmacist did positively affect outcomes that contribute to reimbursement.
当前文献支持药剂师能有效降低糖尿病患者的糖化血红蛋白（HbA1c）水平。但关于药剂师在合并症管理、患者满意度或这些岗位的财务可行性方面的影响，相关数据较少。本研究旨在评估与常规护理相比，药剂师对糖尿病管理的影响。
这项多中心、分两部分的研究包括对一家大型学术医疗系统内转介给药剂师的患者与接受常规护理的患者进行回顾性病历审查。药剂师根据与初级保健医生的咨询协议进行协作。研究的第二部分通过简化的CG-CAHPS调查评估患者满意度。
共纳入206例平均患糖尿病12年的患者。患者平均年龄为62岁，60%为女性，81%为非裔美国人。患者以2:1的比例入组，药剂师管理组有138例患者。药剂师管理组的平均基线HbA1c为10.1%，常规护理组为9.3%（p = 0.0125）。6个月时，干预组和对照组的HbA1c平均变化分别为-2.17%和0.48%（p < 0.001）。
在初级保健诊所中，药剂师在降低HbA1c方面有效，患者对这些服务高度满意。虽然这项服务的直接收入未达到成本，但药剂师确实对有助于报销的结果产生了积极影响。
