Pharmacist-provided diabetes management and education via a telemonitoring program

Laura Shane-McWhorter, Carrie McAdam-Marx, Leslie Lenert, Marta Petersen, Sarah Woolsey, Jeffrey M. Coursey, Thomas C. Whittaker, Christian Hyer, Deb LaMarche, Patricia Carroll, Libbey Chuy

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Objective: To assess clinical outcomes (glycosylated hemoglobin [A1C], blood pressure, and lipids) and other measurements (disease state knowledge, adherence, and self-efficacy) associated with the use of approved telemonitoring devices to expand and improve chronic disease management of patients with diabetes, with or without hypertension. Setting: Four community health centers (CHCs) in Utah. Practice description: Federally qualified safety net clinics that provide medical care to underserved patients. Practice innovation: Pharmacist-led diabetes management using telemonitoring was compared with a group of patients receiving usual care (without telemonitoring). Interventions: Daily blood glucose (BG) and blood pressure (BP) values were reviewed and the pharmacist provided phone follow-up to assess and manage out-of-range BG and BP values. Evaluation: Changes in A1C, BP, and low-density lipoprotein (LDL) at approximately 6 months were compared between the telemonitoring group and the usual care group. Patient activation, diabetes/hypertension knowledge, and medication adherence were measured in the telemonitoring group. Results: Of 150 patients, 75 received pharmacist-provided diabetes management and education via telemonitoring, and 75 received usual medical care. Change in A1C was significantly greater in the telemonitoring group compared with the usual care group (2.07% decrease vs. 0.66% decrease; P <0.001). Although BP and LDL levels also declined, differences between the two groups were not statistically significant. Patient activation measure, diabetes/hypertension knowledge, and medication adherence with antihypertensives (but not diabetes medications) improved in the telemonitoring group. Conclusion: Pharmacist-provided diabetes management via telemonitoring resulted in a significant improvement in A1C in federally qualified CHCs in Utah compared with usual medical care. Telemonitoring may be considered a model for providing clinical pharmacy services to patients with diabetes.

Original languageEnglish (US)
Pages (from-to)516-526
Number of pages11
JournalJournal of the American Pharmacists Association
Volume55
Issue number5
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacology (nursing)
  • Pharmacy
  • Pharmacology

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