Impact of Hybrid Care in Pharmacist-Led Diabetes Clinics on Hemoglobin A1c

Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic, many clinical practices shifted to using virtual platforms to care for patients. After in-person visits resumed, many patients continued to participate in virtual care. Objective: This study evaluated the impact of hybrid care (virtual and in-person visits) on diabetes control in patients seen by clinical pharmacists operating under collaborative drug therapy management (CDTM). Methods: A retrospective chart review was completed for adult (18+) patients with type 2 diabetes (T2D) managed under CDTM protocols in clinical pharmacy ambulatory care clinics. Patients were included if they were discharged between January 2018 to December 2019 (pre-video) or January 2022 to December 2023 (post-video) and had documented baseline and post-intervention hemoglobin A1c (HgbA1c) values. Results: Of the 528 patients that met the inclusion/exclusion criteria, 290 were in the pre-video group and 238 were in the post-video group. There was a non-statistically significant trend toward a greater average decline in HgbA1c in the post-video period (–1.7) compared with the pre-video period (–1.5) (P = 0.239). Secondary outcomes showed the percentage of no-show appointments to be less in the post-video group (7.1 vs 5.2; P = 0.0178) and the mean number of visits to be similar (6.4 vs 6.3; P = 0.5753). Conclusions: A hybrid visit-type model that incorporates video appointments into clinical pharmacy practice provided similar outcomes to traditional in-office/telephone visits. These results demonstrate the importance of ambulatory care pharmacists continuing to offer virtual visit types despite no longer being in a state of emergency.