Clinical pharmacy specialists' impact in patient aligned care teams for type 2 diabetes management

Objectives: Clinical pharmacy specialists (CPSs) are a core member of the primary care team, and they have been shown to improve outcomes, decrease overall cost, and increase the availability of primary care providers (PCPs) by assisting with the management of chronic disease states. CPSs have the opportunity to increase access to care if they are used at their full scope of practice. The objective of this study was to compare the reduction in HbA1c between CPSs and PCPs. Methods: This retrospective, chart review study assessed the impact of CPSs on patients with uncontrolled type 2 diabetes who saw a CPS in addition to a PCP compared to those who saw a PCP alone from January 1, 2011, to October 1, 2016. The CPS held prescriptive authority and ordered, interpreted, and monitored laboratory results. Secondary outcomes included the reduction of blood pressure, appropriate statin intensity, weight loss, initiation of insulin, and access to care. Results: Seventy-five patients were included in both the CPS and PCP groups. There was a statistically significant decrease in HbA1c in the CPS group (3.02% vs. 0.93%; P < 0.0001), with most patients reaching their HbA1c goal in 6 months or less with an average of 7 clinic visits in that timeframe. In addition, significantly more patients were taking the appropriate intensity statin in the CPS group (90.7% vs. 73.3%; P = 0.006). Conclusion: The use of CPSs in the management of type 2 diabetes led to similar achievements in HbA1c goal, but over a shorter duration. CPSs provided effective patient care while increasing access to health care. (C) 2019 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.