Ballard Leigh, York Adriane L, Skelley Jessica W, Sims Marion
Samford University McWhorter School of Pharmacy, Birmingham, AL.
Christ Health Center, Birmingham, AL.
Innov Pharm. 2024 Mar 18;15(1). doi: 10.24926/iip.v15i1.6081. eCollection 2024.
What are the clinical and financial outcomes of patients using a continuous glucose monitor (CGM) as part of a pilot pharmacist-led service in a Federally Qualified Health Center (FQHC)? This single-center, prospective cohort conducted in a FQHC from October 2022 to September 2023 was submitted to IRB for review [EXMT-P-22-F-17]. Patients were seen by a pharmacist in collaboration with an attending physician during diabetes specific visits. A total of 15 patients were seen in the pharmacist-led clinic (5 males and 10 females). While follow-up visits were scheduled in-person every 3 months to obtain a hemoglobin A1c (HbA1c), patients could also be seen in the clinic for additional visits. Reimbursement rates were analyzed to determine financial outcomes of the pharmacy service. Pharmacists saw 15 patients for their initial CGM visits, with 8 patients returning for follow-up. The average HbA1c at the first visit was 10% ± 2.49 and decreased at the last follow-up to 8.05% ± 0.29. Time in range (TIR) was obtained for 8 patients through the CGM device or online data monitoring. The average TIR 2 weeks after the first pharmacist visit was 39.625% ± 23.19 and increased to 48.75% ± 11.41 at the completion of the project. A total of 39 visits were conducted, with a total reimbursement rate of $5,978.54. This pharmacist-led pilot CGM clinic showed improvements in clinical outcomes and provided financial reimbursement for diabetes management in addition to typical office visit revenue. Further research should focus on clinical impact of pharmacist-led continuous glucose monitor clinics in larger patient populations, as well as financial sustainability of the service in both physician clinics and FQHC's.
在联邦合格医疗中心（FQHC），作为由药剂师主导的试点服务的一部分，使用持续葡萄糖监测仪（CGM）的患者的临床和财务结果如何？这项于2022年10月至2023年9月在一家FQHC进行的单中心前瞻性队列研究已提交给机构审查委员会（IRB）进行审查[EXMT-P-22-F-17]。在糖尿病专科就诊期间，药剂师与主治医生合作对患者进行诊治。在药剂师主导的诊所共诊治了15名患者（5名男性和10名女性）。虽然安排了每3个月进行一次面对面的随访以获取糖化血红蛋白（HbA1c），但患者也可以在诊所进行额外的就诊。分析报销率以确定药房服务的财务结果。药剂师对15名患者进行了首次CGM就诊，其中8名患者回来进行随访。首次就诊时的平均HbA1c为10%±2.49，在最后一次随访时降至8.05%±0.29。通过CGM设备或在线数据监测获得了8名患者的血糖达标时间（TIR）。首次药剂师就诊后2周的平均TIR为39.625%±23.19，在项目结束时增至48.75%±11.41。共进行了39次就诊，总报销率为5978.54美元。这个由药剂师主导的CGM试点诊所显示出临床结果有所改善，除了典型的门诊收入外，还为糖尿病管理提供了财务报销。进一步的研究应侧重于在更大规模患者群体中由药剂师主导的持续葡萄糖监测诊所的临床影响，以及该服务在医生诊所和FQHC中的财务可持续性。
