Evaluation of factors associated with achieving glycemic control in a pharmacist-managed diabetes clinic.

Evaluation of factors associated with achieving glycemic control in a pharmacist-managed diabetes clinic.

Kostoff Matthew D; Boros Melanie L; Moorman John M; Frazee Lawrence A

American Journal of Therapeutics

2014

2014-08

The aim of this study was to identify factors that are associated with patients achieving goal A1c after 6 months in a pharmacist-managed diabetes clinic. This study is a descriptive, retrospective chart review of patients with type 2 diabetes enrolled in a pharmacist-managed diabetes clinic. The primary endpoint was the odds of each identified factor being associated with achievement of goal A1c after 6 months of enrollment. The factors were also evaluated within 2 subgroups: those with a baseline A1c \textgreater7% and those with a baseline A1c \textgreater9%. Of 112 patients enrolled, 58 were included in the analysis. There was a positive association with reaching goal for patients who had \textless1 failure to show (FTS) to office visits in 6 months [odds ratio (OR) 8.10, 95% confidence interval (CI) 1.47-58.65], had canceled or FTS to \textless50% of office visits (OR 10.0, 95% CI 1.8-72.79), and brought \textgreater75% of blood glucose logs to their office visits (OR 7.36, 95% CI 1.87-30.88). There was a negative association with reaching the goal for patients with documented social worker involvement (OR 0.22, 95% CI 0.04-0.99) and noninsulin or insulin dose increases at \textgreater50% of office visits (OR 0.10, 95% CI 0.01-0.55). Overall, this analysis found that patients who had \textless1 FTS, had canceled or FTS to \textless50% of office visits, or who brought \textgreater75% logs to office visits were more likely to achieve goal A1c, whereas patients with social work assistance or dose increases at \textgreater50% of office visits were less likely to reach goal A1c.

Ambulatory Care; Ambulatory Care/organization & administration; Blood Glucose – Drug Effects; Blood Glucose/drug effects; Diabetes Mellitus; Dose-Response Relationship; Drug; Female; Follow-Up Studies; Glycated Hemoglobin A/metabolism; Glycosylated – Metabolism; Hemoglobin A; Human; Humans; Hypoglycemic Agents – Administration and Dosage; Hypoglycemic Agents – Therapeutic Use; Hypoglycemic Agents/administration & dosage/*therapeutic use; Insulin – Administration and Dosage; Insulin – Therapeutic Use; Insulin/administration & dosage/therapeutic use; Male; Middle Age; Middle Aged; Pharmaceutical Services/*organization & administration; Pharmacists – Administration; Pharmacists/*organization & administration; Pharmacy Service – Administration; Prospective Studies; Retrospective Design; Retrospective Studies; Social Work – Statistics and Numerical Data; Social Work/statistics & numerical data; Treatment Outcome; Treatment Outcomes; Type 2 – Drug Therapy; Type 2/*drug therapy

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