Community Pharmacists' Impact on an Employer-Initiated Diabetes Disease Management Program

Abstract

Background:

Diabetes is the third most expensive physical health condition for US employers. Thus, there is a need for employers to engage in disease management programs for their diabetic employees in order to ensure long-term benefits.

Objective:

To evaluate the clinical outcomes of successful implementation of an employer-initiated pharmacist-based disease management program for diabetic patients.

Methods:

This was a longitudinal retrospective study analyzing clinical indicators in diabetic employees after a community pharmacist-based diabetes disease management (DDM) program in a rural setting. The program involved comprehensive drug therapy assessment and individualized disease management education. Outcomes measured in this study were fasting serum glucose (FSG) levels, glycated hemoglobin (A1C) levels, diastolic blood pressure (DBP), systolic blood pressure (SBP), body mass index (BMI), and complete lipid profiles including high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and total cholesterol (TC) levels.

Results:

A total of 137 patients were enrolled in this program. Significant improvement in mean clinical outcome scores was achieved for FSG (p = 0.004), DBP (p = 0.018), and SBP (p = 0.044). At the end of the 1-year intervention, targeted FSG and A1C goals were attained by 39.1% (p = 0.029) and 39.4% of patients, respectively. Also, targeted DBP, SBP, BMI, LDL, HDL, TG, and TC levels were achieved by 54.8% (p < 0.001), 38.5%, 38.3%, 56.8%, 38.2%, 37.5%, and 52.4% of patients, respectively.

Conclusions:

This study establishes a need for implementation of long-term employer-initiated pharmacist-based DDM programs that improve clinical outcomes for employees. Further studies evaluating outcomes for a longer time period would provide more conclusive results.