Williams Emma, Simkins Haley, Hale Anna, Trejo Luis, Carrington Warren Anne C
University of North Carolina, Eshelman School of Pharmacy.
Mountain Area Health Education Center.
Innov Pharm. 2024 May 31;15(2). doi: 10.24926/iip.v15i2.5773. eCollection 2024.
: Access to a primary care provider is not guaranteed for many living in rural settings. Notably, rural populations experience a higher degree of burden from chronic diseases compared to urban-dwellers. For example, diabetes can go undiagnosed and undertreated with lack of primary care. To address these care gaps at a large, rural family medicine practice in western North Carolina, a multidisciplinary pharmacist-led diabetes clinic was developed. : This article describes the implementation, evolution, and impact of the diabetes management clinic and explores future directions for improving the experience of patients and health care providers. : The diabetes management clinic at Mountain Area Health Education Center (MAHEC) is a pharmacy resident-led interdisciplinary clinic incorporating nutrition and pharmacy learners to provide patient care in both telehealth and in-office settings. Since its inception in 2018, the clinic has facilitated meaningful learning opportunities for students and residents and helped patients manage their diabetes in a multifaceted approach. : A retrospective, cross-sectional study evaluated diabetes-related outcomes for 80 patients seen in the diabetes management clinic during twelve months of appointments. The primary outcome measure was change in A1c from baseline. : Among patients with a follow-up A1c during the study (n=64), there was a mean reduction in A1c by 0.79% from baseline. Additionally, among those with a second follow-up A1c available (n=32), there was a mean reduction from baseline in A1c of 1.42%. : The utilization of pharmacy residents as part of an interdisciplinary diabetes management clinic can extend access to care for underserved patients. The clinic also serves as a structured teaching clinic for interdisciplinary learners, and it has contributed to positive clinical outcomes, strong interprofessional collaboration, and expansion of experiential education opportunities since its inception in 2018.
许多生活在农村地区的人无法保证能获得初级保健服务。值得注意的是，与城市居民相比，农村人口患慢性病的负担更重。例如，由于缺乏初级保健服务，糖尿病可能无法得到诊断和充分治疗。为了大规模解决这些医疗服务差距问题，在北卡罗来纳州西部的一家农村家庭医学诊所，设立了一个由多学科药剂师主导的糖尿病诊所。
本文描述了糖尿病管理诊所的实施、发展及影响，并探讨了改善患者和医疗服务提供者体验的未来方向。
山区健康教育中心（MAHEC）的糖尿病管理诊所是一个由药学住院医师主导的跨学科诊所，吸纳了营养学和药学专业的学习者，在远程医疗和门诊环境中为患者提供护理服务。自2018年成立以来，该诊所为学生和住院医师提供了有意义的学习机会，并以多方面的方式帮助患者管理糖尿病。
一项回顾性横断面研究评估了在糖尿病管理诊所接受为期十二个月诊疗的80名患者的糖尿病相关结果。主要结果指标是糖化血红蛋白（A1c）相对于基线的变化。
在研究期间有随访A1c数据的患者中（n = 64），A1c相对于基线平均降低了0.79%。此外，在有第二次随访A1c数据的患者中（n = 32），A1c相对于基线平均降低了1.42%。
将药学住院医师纳入跨学科糖尿病管理诊所，可以扩大为服务不足的患者提供的医疗服务范围。该诊所还作为跨学科学习者的结构化教学诊所，自2018年成立以来，它为积极的临床结果、强大的跨专业合作以及实践教育机会的扩展做出了贡献。
