TY - JOUR
T1 - Pharmacist-provided diabetes management and education via a telemonitoring program
AU - Shane-McWhorter, Laura
AU - McAdam-Marx, Carrie
AU - Lenert, Leslie
AU - Petersen, Marta
AU - Woolsey, Sarah
AU - Coursey, Jeffrey M.
AU - Whittaker, Thomas C.
AU - Hyer, Christian
AU - LaMarche, Deb
AU - Carroll, Patricia
AU - Chuy, Libbey
N1 - Funding Information:
The objective of this study was 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. This report is part of a larger study funded by the Office for the Advancement of Telehealth, Health Resources and Service Administration, U.S. Department of Health and Human Services.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - 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.
AB - 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.
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U2 - 10.1331/JAPhA.2015.14285
DO - 10.1331/JAPhA.2015.14285
M3 - Article
C2 - 26359961
AN - SCOPUS:84941925292
SN - 1544-3191
VL - 55
SP - 516
EP - 526
JO - Journal of the American Pharmacists Association
JF - Journal of the American Pharmacists Association
IS - 5
ER -