Pharmacist-led group medical appointment model in type 2 diabetes

Diabetes Educ. Jan-Feb 2010;36(1):109-17. doi: 10.1177/0145721709352383. Epub 2009 Dec 4.

Abstract

Purpose: The purpose of this study was to assess whether the VA-MEDIC (Veterans Affairs Multi-disciplinary Education and Diabetes Intervention for Cardiac risk reduction), a pharmacist-led group medical visit program, could improve achievement of target goals in hypertension, hyperglycemia, hyperlipidemia, and tobacco use in patients with type 2 diabetes compared to usual care.

Methods: This was a randomized controlled trial of VA-MEDIC intervention in addition to usual care versus usual care alone in diabetic patients to reduce cardiac risk factors. VA-MEDIC consisted of a 40- to 60-minute educational component by nurse, nutritionist, physical therapist, or pharmacist followed by pharmacist-led behavioral and pharmacological interventions over 4 weekly sessions. Measures The attainment of target goals in hemoglobin A1C (A1C), blood pressure, fasting lipids, and tobacco use recommended by the American Diabetes Association.

Results: Of 118 participants, 109 completed the study. VA-MEDIC (n = 58) participants were younger and had greater tobacco use at baseline than usual care but were similar in other cardiovascular risk factors. After 4 months, a greater proportion of VA-MEDIC participants versus controls achieved an A1C of less than 7% and a systolic blood pressure less than 130 mm Hg. No significant change was found in lipid control or tobacco use between the 2 study arms.

Conclusion: Pharmacist-led group medical visits are feasible and efficacious for improving cardiac risk factors.

Trial registration: ClinicalTrials.gov NCT00357955.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Appointments and Schedules*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / rehabilitation*
  • Diabetic Angiopathies / prevention & control*
  • Glycated Hemoglobin A / metabolism
  • Heart Diseases / prevention & control
  • Humans
  • Lipids / blood
  • Patient Compliance*
  • Patient Education as Topic*
  • Patient Selection
  • Pharmacists*

Substances

  • Glycated Hemoglobin A
  • Lipids

Associated data

  • ClinicalTrials.gov/NCT00357955