Objectives:
Pharmacist-managed collaborative services in a family practice
setting are described, and diabetes and hypertension outcomes
are assessed.
Methods: Pharmacist-managed clinics, pharmacotherapy consultations,
and drug information services are provided for a medically underserved,
predominantly African American population. A pharmacy residency
director, an ambulatory care pharmacy resident and three PharmD
candidate student pharmacists work directly with physicians, nurse
practitioners, nurses, and social workers to form an interdisciplinary
health care team. Providers utilize pharmacy services through
consultations and referrals. Collaboration outcomes were evaluated
in twenty-two patients with diabetes and thirty hypertensive patients.
Patients were retrospectively followed throughout their history
with pharmacy service. Hemoglobin A1c (A1C) was tracked before
referral to pharmacy services, 3 to 6 months after, and as the
most current measure after at least 6 months. Blood pressure (BP)
was observed before pharmacy involvement, 2 to 4 months later,
and then currently for at least 4 months with the service. The
mean of the most current markers was calculated, and the percent
of patients at their goal marker was compared to national averages.
Results: Fifty percent of pharmacy service patients met the American
Diabetes Association hemoglobin A1c goal of less than 7% in our
evaluation compared to the national mean of 49.8% overall and
44% in African Americans. Thirty percent of patients were at their
BP goal while 33.1% of patients without diabetes and 33.2% of
patients with diabetes nationally are at goal.
Conclusion: The medically underserved patients under the care
of pharmacy services achieved a higher percentage at their A1C
goal than the national mean. The percentage of patients who achieved
their BP goals was comparable to the national average. Increasing
utilization of pharmacy services in the family practice setting
allows for pharmacists and providers to form a trusted relationship
while providing enhanced care and potentially improved outcomes
for patients.
