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

Abstract

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.