The Pharmacist's Role in Continuity of Care in Type 2 Diabetes: An Evaluation of a Model

Abstract

Background:

Evidence suggests that many patients with type 2 diabetes are not achieving current evidence-based therapeutic targets.

Objective:

To compare the impact of a clinic-only versus continuity-of-care model on clinical and humanistic outcomes of patients with type 2 diabetes.

Methods:

One hundred eighteen patients were recruited from 2 diabetes clinics and assigned to a clinic-only or continuity-of-care group. The clinic-only patients were assessed by the clinic pharmacist at the initial visit and attended their usual pharmacy until the follow-up clinic visit 6 months later. The continuity-of-care patients were referred to one of 20 participating pharmacies for ongoing care over 6 months. The evaluation used a repeated measures design and compared the clinic-only with the continuity-of-care groups.

Results:

Within the continuity-of-care group, there was a significant reduction in mean blood glucose over the 6 months (p = 0.04). Compared with the clinic-only group, the continuity-of-care model demonstrated a trend toward a greater improvement in glycemic control. The net benefit of the intervention was an additional 0.27% (95% CI −0.63% to 0.009%) reduction in hemoglobin A_1c (p = 0.15). Improvements in negative attitude and understanding of diabetes were seen in both groups; however, improvements in positive attitude to diabetes were seen only in the continuity-of-care group.

Conclusions:

The continuity-of-care model had a significant impact on clinical and humanistic outcomes. Community pharmacists may enhance the care of patients with type 2 diabetes.