Utilizing Clinical Pharmacy Specialists to Address Access to Care Barriers in the Veteran Population for the Management of Diabetes

Utilizing Clinical Pharmacy Specialists to Address Access to Care Barriers in the Veteran Population for the Management of Diabetes

Objective: To show that clinical pharmacy specialists (CPSs) can be utilized in remote facilities to provide appropriate diabetes outcomes along with potential cost savings. Methods: A retrospective cohort chart review conducted at the Veterans Affairs North Texas Healthcare System (VANTHCS) evaluat...

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Bibliographic Details
Published in:Journal of pharmacy practice Vol. 30; no. 4; pp. 412 - 418
Main Authors: Edwards, Krystal L., Hadley, Ryan L., Baby, Nidhu, Yeary, Julianne C., Chastain, Lisa M., Brown, Crystal D.
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 01-08-2017
Subjects:
Aged
Cohort Studies
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - therapy
Disease Management
Female
Health Services Accessibility
Hospitals, Veterans - utilization
Humans
Male
Middle Aged
Pharmacists - utilization
Pharmacy Service, Hospital - utilization
Retrospective Studies
Veterans
clinical pharmacy specialist
veterans
diabetes mellitus
access to care
HbA1c
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Summary:Objective: To show that clinical pharmacy specialists (CPSs) can be utilized in remote facilities to provide appropriate diabetes outcomes along with potential cost savings. Methods: A retrospective cohort chart review conducted at the Veterans Affairs North Texas Healthcare System (VANTHCS) evaluated outcomes in patients with type 2 diabetes mellitus referred to CPSs at Fort Worth Outpatient Clinic (FWOPC) or the endocrinologist-managed specialty clinic at the Dallas VA Medical Center (DVAMC). The primary outcome was percentage of patients reaching hemoglobin A1c (HbA1c) goal of <8%. Secondary outcomes were percentage of patients reaching HbA1c <7%, time to reach HbA1c goals of <8% and <7%, and cost savings. Results: There was no statistically significant difference in the number of patients reaching HbA1c goal <8% in the FWOPC (65.3%) compared to the DVAMC (55.8%). Secondary end points comparing FWOPC and DVAMC found no difference in patients reaching HbA1c <7% (20.8% vs 19.2%) and time to reach HbA1c goal of <8% (4.5 vs 6 months) and <7% (8.5 vs 7.5 months). Cost-saving analysis demonstrated a composite of US$350 292 could be saved by the VANTHCS facility if patients continued to be referred to CPS. Conclusion: CPSs can be utilized in diabetes management to provide similar health outcomes as the endocrinologist-managed clinic and to potentially allow for facility cost savings.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0897-1900
1531-1937
DOI:10.1177/0897190016663952