Evaluation of hemoglobin A1c reduction in Hispanic patients versus non-Hispanic patients with type 2 diabetes managed by a clinical pharmacist

BackgroundHispanic people are 1.6 times as likely to be diagnosed with type 2 diabetes mellitus (T2DM) as non-Hispanic White people. Clinical pharmacists can play a significant role in helping patients disproportionately affected by diabetes meet hemoglobin A1c (A1c) goals through medication management via collaborative practice agreements (CPAs).ObjectiveThe objective of this study was to evaluate A1c reduction in Hispanic and non-Hispanic patients with T2DM when managed by a clinical pharmacist utilizing a CPA.MethodsA single-center, retrospective, observational cohort study was conducted from August 30, 2019 to August 30, 2022. Patients were included if they were at least 18 years of age, diagnosed with T2DM, and had at least one office visit with a clinical pharmacist for diabetes management at John Peter Smith (JPS) Health Network. The study population was subdivided into two groups: Hispanic and non-Hispanic patients. The primary outcome was mean A1c reduction, defined as the difference in A1c at baseline and 12 months. Secondary outcomes included differences in variables for Hispanic patients who reached A1c goals versus those who did not.ResultsData points were collected within 1 year from the first encounter with a clinical pharmacist. Three hundred patients were enrolled in the study, with 150 patients in each group. The mean A1c reduction in the Hispanic group was 1.6% (standard deviation [SD] = 2.654, 95% confidence interval [CI] [1.180-2.030]) and 2.0% (SD = 2.369, 95% CI [1.598-2.356]) in the non-Hispanic group (p = 0.20). There were no significant differences in variables for Hispanic patients who met A1c goals compared to Hispanic patients who did not achieve A1c goals. There was no significant difference in A1c reduction between Hispanic and non-Hispanic patients with T2DM who were managed by a clinical pharmacist utilizing a CPA.ConclusionsThe findings from this study suggest that clinical pharmacist management of T2DM does not further contribute to the disparities experienced by Hispanic patients, but rather, it can serve as a valuable resource in their care.