PMID- 15868754
OWN - NLM
STAT- MEDLINE
DCOM- 20060818
LR  - 20221207
IS  - 1544-3191 (Print)
IS  - 1086-5802 (Linking)
VI  - 45
IP  - 2
DP  - 2005 Mar-Apr
TI  - Patient self-management program for diabetes: first-year clinical, humanistic, 
      and economic outcomes.
PG  - 130-7
AB  - OBJECTIVE: To assess the outcomes for the first year following the initiation of 
      a multisite community pharmacy care services (PCS) program for patients with 
      diabetes. DESIGN: Quasi-experimental, pre-post cohort study. SETTING: 80 
      community pharmacy providers with diabetes certificate program training who were 
      reimbursed for PCS by employers in Greensboro, N.C., Wilson, N.C., Dublin, Ga., 
      Manitowoc County, Wis., and Columbus, Ohio. PATIENTS: 256 patients with diabetes 
      covered by self-insured employers' health plans. INTERVENTIONS: Community 
      pharmacist patient care services using scheduled consultations, clinical goal 
      setting, monitoring, and collaborative drug therapy management with physicians 
      and referrals to diabetes educators. MAIN OUTCOME MEASURES: Changes in 
      glycosylated hemoglobin (AIC), low-density lipoprotein cholesterol (LDL-C), blood 
      pressure, influenza vaccinations, foot examinations, eye examinations, patient 
      goals for nutrition, exercise, and weight, patient satisfaction, and changes 
      medical and medication utilization and costs. RESULTS: Over the initial year of 
      the program, participants' mean A1C decreased from 7.9% at initial visit to 7.1%, 
      mean LDL-C decreased from 113.4 mg/dL to 104.5 mg/dL, and mean systolic blood 
      pressured decreased from 136.2 mm Hg to 131.4 mm Hg. During this time, influenza 
      vaccination rate increased from 52% to 77%, the eye examination rate increased 
      from 46% to 82%, and the foot examination rate increased from 38% to 80%. Patient 
      satisfaction with overall diabetes care improved from 57% of responses in the 
      highest range at baseline to 87% at this level after 6 months, and 95.7% of 
      patients reported being very satisfied or satisfied with the diabetes care 
      provided by their pharmacists. Total mean health care costs per patient were $918 
      lower than projections for the initial year of enrollment. CONCLUSION: Patients 
      who participated in the program had significant improvement in clinical 
      indicators of diabetes management, higher rates of self-management goal setting 
      and achievement, and increased satisfaction with diabetes care, and employers 
      experienced a decline in mean projected total direct medical costs.
FAU - Garrett, Daniel G
AU  - Garrett DG
AD  - American Pharmacists Association Foundation, Washington, D.C. 20037-2985, USA. 
      dgarrett@aphanet.org
FAU - Bluml, Benjamin M
AU  - Bluml BM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Blood Pressure/drug effects/physiology
MH  - Cholesterol, LDL/blood
MH  - Cohort Studies
MH  - Community Pharmacy Services/economics/standards/*statistics & numerical data
MH  - Diabetes Mellitus/blood/physiopathology/*prevention & control
MH  - Drug Utilization/economics/statistics & numerical data
MH  - Exercise/physiology
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Insurance, Pharmaceutical Services/economics/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/economics/methods
MH  - Patient Satisfaction/economics/statistics & numerical data
MH  - Pilot Projects
MH  - Program Evaluation/*statistics & numerical data
MH  - Self Care/*methods
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2005/05/05 09:00
MHDA- 2006/08/19 09:00
CRDT- 2005/05/05 09:00
PHST- 2005/05/05 09:00 [pubmed]
PHST- 2006/08/19 09:00 [medline]
PHST- 2005/05/05 09:00 [entrez]
AID - S1544-3191(15)31704-0 [pii]
AID - 10.1331/1544345053623492 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2005 Mar-Apr;45(2):130-7. doi: 10.1331/1544345053623492.