Blood Alexander J, Saag Harry, Chesler Adam, Ameripour Dalia, Gutierrez Max, Nguyen Van, Richardson Cassandra, Fields Clive, Clair Jen, Yao Aaron, Moodley Sashi
Walgreen Co, Deerfield, IL, USA.
Village Medical, Chicago, IL, USA.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319241312041. doi: 10.1177/21501319241312041.
INTRODUCTION/OBJECTIVES: Patients living with chronic diseases require more medical attention, including more visits to primary care. However, primary care providers are overburdened, and this specialty is attracting fewer new providers than before. Clinical pharmacists can augment these efforts by improving disease state control. In this cohort study, we aimed to demonstrate a retail pharmacy hired and trained clinical pharmacist within a value-based primary care clinic network can improve hypertension (HTN) and type 2 diabetes mellitus (T2DM) control.
In this cohort study, a pharmacist, enabled by a collaborative drug therapy management agreement, prescribed and titrated therapies for HTN and T2DM. Primary outcomes were pre- to post-index changes in hemoglobinA1c, systolic, and diastolic blood pressure (BP) measures.
The HTN cohort consisted of 43 patients and the T2DM cohort consisted of 125 patients. The difference-in-differences (β) in the HTN group was -10.2 mmHg ( < .01) for systolic BP and -2.0 mmHg ( = .42) for diastolic BP. The β in the T2DM group was -1.16% ( < .001).
Statistically significant reductions in systolic BP and hemoglobinA1c were observed in the pharmacist-managed group compared with matched controls. These results demonstrate that pharmacist integration into a value based primary care clinic may improve measures of chronic disease associated with morbidity and mortality.
引言/目的：慢性病患者需要更多的医疗关注，包括增加对初级保健的就诊次数。然而，初级保健提供者负担过重，而且该专业吸引的新提供者比以前更少。临床药师可以通过改善疾病状态控制来加强这些努力。在这项队列研究中，我们旨在证明在基于价值的初级保健诊所网络中受雇并经过培训的零售药房临床药师可以改善高血压（HTN）和2型糖尿病（T2DM）的控制情况。
在这项队列研究中，一名药师根据合作药物治疗管理协议，为高血压和2型糖尿病开出处方并调整治疗方案。主要结局指标为血红蛋白A1c、收缩压和舒张压（BP）测量值在索引前后的变化。
高血压队列包括43名患者，2型糖尿病队列包括125名患者。高血压组收缩压的差值（β）为-10.2 mmHg（P < 0.01），舒张压的差值为-2.0 mmHg（P = 0.42）。2型糖尿病组的β为-1.16%（P < 0.001）。
与匹配的对照组相比，在药师管理的组中观察到收缩压和血红蛋白A1c有统计学意义的降低。这些结果表明，将药师纳入基于价值的初级保健诊所可能会改善与发病率和死亡率相关的慢性病指标。
