Pharmacist-physician collaborative care effective in T2DM

Pharmacists working in a collaborative relationship with physicians in different practice settings were able to help more patients with type 2 diabetes achieve glycemic control without adding to the medication burden, according to a report published May 8 in The Annals of Pharmacotherapy.

Michelle Z. Farland, PharmD, BCPS, of the College of Pharmacy, Health Science Center, University of Tennessee, Knoxville, and her colleagues enrolled more than 200 patients with type 2 diabetes from seven practice sites in Tennessee for the 12-month study. Before the prospective multicenter study started, the collaborative teams of pharmacists and physicians were developed. The majority of the patients were male (60%) and white (66%), with a mean age of 60 years.

The researchers followed patients for 1 year to determine any improvement in hemoglobin A1c levels and the proportion of patients who achieved A1c levels less than 7%, the goal for glycemic control established by the American Diabetes Association and the European Association for the Study of Diabetes. They also wanted to determine the percentage of patients with A1c levels greater than 9%.

At the end of the study, the A1c levels declined by an average of 1.16% (P <.0001). More than one-third of the patients achieved A1c levels less than 7%, compared to about 13% at baseline (P=.0002). In addition, only 16.5% of patients had A1c levels greater than 9% at the study’s end, compared with 34% at baseline (P <.0001).

“Pharmacist-physician collaborative management at multiple practice locations and types of setting (e.g., private, academic, Veterans Affairs medical center) has a positive impact on glycemic control and diabetes-related health maintenance,” the authors wrote. “This was accomplished without increasing the total number of antihyperglycemic agents prescribed and without an increase in patient-reported episodes of hypoglycemia.”