Outcomes of a community pharmacy-based diabetes monitoring program.
PRIMARY OBJECTIVE: Evaluate the effects of a point-of-dispensing (POD) pharmaceutical care model on outcomes of self-monitored blood glucose (SMBG) results, SMBG frequency, and medication adherence rates for patients with diabetes. SECONDARY OBJECTIVE: Measure the rate at which physicians implemented therapy recommendations made by community pharmacists. DESIGN: 12-month, noncrossover, single-group trial. SETTING: Two independent community pharmacies in Richmond, Va. PATIENTS: 101 patients were initially identified as potential participants; of the 82 that elected to participate in the study, 62 (76%) completed the first 6 months and 52 (63%) completed the entire 12-month study period. INTERVENTION: This pharmaceutical care program was integrated into the dispensing function: subjective and objective data related to diabetes care were gathered with each prescription refill. Recommendations were made to patients and their physicians. MAIN OUTCOME MEASURES: SMBG values and frequency at baseline, 6, and 12 months. Diabetic medication adherence rates for 1 year before and during participation were evaluated. Community pharmacist recommendations and implementation status were followed over the 12-month period. RESULTS: Average morning blood glucose values (n = 27) decreased from 178.6 mg/dL to 159.3 mg/dL, from baseline to 6 months, respectively (p = .07). Blood glucose values (n = 23) at baseline and 12 months decreased from 179.0 mg/dL to 149.7 mg/dL, respectively (p < .05). There was no statistical difference in SMBG frequency. A diabetes medication adherence rate of 90% was maintained over the 12-month study period. Physicians implemented 15 of 20 (75%) recommendations. CONCLUSION: This model offers an effective and efficient mechanism for providing pharmaceutical care for patients with diabetes.