Impact of Physician-Pharmacist Covisits at a Primary Care Clinic in Patients With Uncontrolled Diabetes

Purpose: A popular method for enhancing medication management within a patient-centered medical home (PCMH) is the physician-pharmacist collaborative management (PPCM) model. To improve efficiency of health-care delivery within 4 federally qualified health centers (FQHCs), the PPCM model was implemented through coordinated physician-pharmacist covisits. Objective: To evaluate the impact of physician-pharmacist covisits on clinical outcomes among patients with uncontrolled diabetes. Methodology: This was a retrospective multicenter cohort study including adults (>= 18 years old) with uncontrolled type 1 or type 2 diabetes (hemoglobin A(1c) [HbA(1c)] >= 8 %) who had at least one covisit between January 1, 2013, and October 1, 2016. The primary clinical metric was mean change in HbA(1c) from baseline to follow-up. Secondary outcomes included adherence to select American Diabetes Association (ADA) Standards of Medical Care. Results: A total of 106 patients were included in this analysis. Patients who were managed in the PPCM model experienced a significant decrease in mean change in HbA(1c) from baseline to follow-up (-1.75 [2.63], P < .001). There was no significant difference in the proportion of patients receiving recommended vaccinations or cardiovascular (CV) risk reduction medications. Conclusion: The results suggest that physician-pharmacist covisits may improve glucose control in patients with uncontrolled diabetes.