Clinical outcomes of patients with diabetes mellitus receiving medication management by pharmacists in an urban private physician practice

Purpose. The clinical outcomes of patients with diabetes mellitus in an urban environment receiving pharmacist medication management in collaboration with private-practice physicians were assessed. Methods. Patients older than 18 years with type 1 or 2 diabetes mellitus who were receiving oral and insulin therapy and who were referred to a pharmacy clinic within a private physician practice for medication management between March 1, 2002, and August 31, 2003, were eligible for study inclusion. Data were collected at three junctures: six months before the first visit with the pharmacist (preperiod measure), on the date of clinic entry (index measure), and six months after the first clinic visit (postperiod measure). Primary outcomes analyzed were glycosylated hemoglobin (HbA_1c), weight, and blood pressure (goal, <130/80 mm Hg). Secondary outcomes analyzed were smoking cessation and initiation of aspirin, angiotensin-converting-enzyme inhibitor, or angiotensin receptor blocker therapy. Results. A significant reduction in HbA_1c from the index measure to the postperiod measure was observed (p < 0.001). No significant change was noted in weight or number of patients at goal blood pressure among the preperiod, index, and postperiod measures. No change was observed in the secondary outcomes during the study time intervals. Conclusion. Integrating a pharmacist into a private physician practice significantly improved patient glycemic control and maintained patients' weight and the number of patients at blood pressure goal. Clinic adherence with the American Diabetes Association recommendations was sustained.