Pharmacist-led phone call initiative targeting hemoglobin A1c levels in patients with uncontrolled diabetes

Purpose Pharmacist-led telemedicine initiatives have been shown to lower hemoglobin A1c (HbA1c) levels compared with usual care, but few studies have targeted patients with uncontrolled diabetes in the rural setting. The purpose of this study was to evaluate the impact of a pharmacist-led diabetes telemedicine initiative on HbA1c in patients with uncontrolled diabetes at a family medicine clinic in rural North Carolina. Methods Pharmacists implemented a telemedicine initiative to help manage patients with uncontrolled diabetes at a large, rural family medicine clinic. Adult patients with uncontrolled diabetes were identified through a generated report or by provider referrals. Pharmacy residents called each patient and documented type of interventions, demographic information, and HbA1c results. Patients were followed within a time period of 18 months (September 2018-March 2020). Results A total of 64 patients were successfully contacted by the telemedicine program. The patients were primarily non-Hispanic, white patients (50% female) with type 2 diabetes on insulin. The most common interventions that patients received included general education (68.8%), scheduling labs (51.6%), insulin titration (51.6%), and facilitating medication access (50.0%). For patients who had been in the telemedicine program long enough to have had an HbA1c lab completed post-contact (n = 46), there was a significant reduction of 1.15 in mean HbA1c (t = -3.5, P < .01) compared with their initial HbA1c prior to receiving phone calls. Conclusion A pharmacist-led diabetes telemedicine program was associated with a reduction in HbA1c for patients with uncontrolled diabetes in a rural family practice.