Glycosylated hemoglobin, cardiovascular, and renal outcomes in a pharmacist-managed clinic

Ann Pharmacother. 2004 May;38(5):771-5. doi: 10.1345/aph.1D359. Epub 2004 Mar 18.

Abstract

Background: Pharmacists' responsibilities in caring for patients with diabetes mellitus are expanding. However, few data are available to support pharmacists optimizing therapy and improving outcomes in these patients.

Objective: To determine the effect of a clinical pharmacist-directed diabetes management clinic on glycemic control and cardiovascular and renal parameters in patients with type 2 diabetes.

Methods: A nonrandomized, prospective study was conducted in 70 Veterans Affairs patients. Patients met with the pharmacist every 6-8 weeks for approximately 30 minutes for education, medication counseling, monitoring, and management. The primary endpoint was the impact of 9-12 months of participation in the clinic on glycosylated hemoglobin (HbA1C). Secondarily, we evaluated body weight, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure, and level of microalbuminuria. All comparisons were made using a paired t-test at a significance level of p < or = 0.05.

Results: HbA1C significantly decreased from 10.3% +/- 2.2% at baseline to 6.9% +/- 1.1% (mean +/- SD) during the 9- to 12-month evaluation period (p < 0.001). The secondary endpoints including systolic (p < 0.001) and diastolic (p < 0.001) blood pressure, total cholesterol (p < 0.001), LDL-C (p < 0.001), triglycerides (p = 0.006), and level of microalbuminuria (p < 0.001) also were reduced at 9-12 months.

Conclusions: This study demonstrated that a clinical pharmacist can effectively care for patients with diabetes referred by their primary care provider because of poor glycemic control.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Albuminuria / diagnosis*
  • Ambulatory Care Facilities / organization & administration*
  • Blood Pressure*
  • Diabetes Mellitus, Type 2 / therapy*
  • Drug Monitoring / methods
  • Female
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Lipoproteins / blood
  • Male
  • Patient Education as Topic
  • Pharmaceutical Services / organization & administration*
  • Prospective Studies
  • Treatment Outcome

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Lipoproteins