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Pharmacist-Endocrinologist Diabetes Clinic Impact on Glycemic Control

June 27, 2018

Patients with type 2 diabetes who are treated with a collaborative pharmacist-endocrinologist Diabetes Intense Medical Management (DIMM) clinical model, achieved better glycemic control without increasing medication regimen complexity, according to a recent study published in the Annals of Pharmacotherapy.

Often times, in order to achieve improved glycemic control, patients with type 2 diabetes usually require more complicated medication regimens. The researchers, led by Candis Morello, PharmD, and colleagues, compared medication regimen complexity changes in patients with uncontrolled type 2 diabetes to a DIMM “tune up” model versus patients receiving usual primary care provider care over 6 months.

The retrospective, observational, comparative cohort study compared medication regimen complexity of complex DIMM clinic patients to a similar group—adults with type 2 diabetes, glycosylated hemoglobin [A1C] ≥8%), continuing to receive usual care from their primary care providers.

According to the findings, the DIMM (n=99) and primary care provider (n=56) groups were similar. The high baseline mean MRC scores as measured by number of medications and MRC Index (12.0 [SD=5.7] vs 13.7 [SD = 5.6], and 32.7 [SD=17.0] vs 38 [SD=16.5]), respectively. Over 6 months, the mean MRC change was not significantly different between groups.

Notably, mean A1C reduction was significantly greater in the DIMM versus primary care provider group (-2.4% [SD=2.1] vs -0.8% [SD=1.7], P<0.001, respectively).

“Outcomes represent the first report demonstrating how treating patients with an innovative DIMM model can help complex type 2 diabetes patients achieve glycemic control without increasing the medication regimen complexity to more than a comparator group,” Dr Morello and colleagues concluded. “With the growing prevalence of type 2 diabetes and associated elevated treatment costs, identifying effective means for achieving glycemic control without increasing complexity is needed.”

The researchers noted that the application of this model may be considered by other health systems to aid in achieved outcome measures.

Julie Gould

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