Cicconetti, Jennifer, PharmD, BCPS, BCGP

Geerlof, Lauren, BCPS

Mauro, Laura M, BS, PharmD, BCPS

Omari-Okyere, Michelle, BS, PharmD, BCPS, BCGP

Sperrazza, Frank, DO

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works Department of Pharmacy Working Together to Improve Outcomes: Physician-Pharmacist Collaborative Agreement for Uncontrolled Type 2 Diabetes Frank Sperrazza DO Laura M. Mauro BS, PharmD, BCPS Lauren Geerlof BCPS Jennifer Cicconetti PharmD, BCPS, BCGP Michelle Omari-Okyere BS, PharmD, BCPS, BCGP Follow this and additional works at: https://scholarlyworks.lvhn.org/pharmacy  Part of the Pharmacy and Pharmaceutical Sciences Commons This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. © 2019 Lehigh Valley Health NetworkLVHN.orgWorking Together to Improve Outcomes: Physician-Pharmacist Collaborative Agreement for Uncontrolled Type 2 DiabetesFrank Sperrazza, DO; Laura Mauro, BS, PharmD, BCPS; Lauren Geerlof, PharmD, BCPS; Jennifer Cicconetti, PharmD, BCPS, BCGP; Michelle Omari-Okyere, BS, PharmD, BCPS, BCGPLehigh Valley Health Network, Allentown, PennsylvaniaBACKGROUND•  Diabetes affects over 30 million people in the United States1   1 out of every 10 people have diabetes   7th leading cause of death•  Clinical Inertia2Health Care System• Difficulty managing too many medications• Medication costs• Lack of time• Lack of information on new treatment options• No clinical guidelines• Lack of multidisciplinary care teamsPatient Physician•  Physician-pharmacist collaborative practice agreements (CPAs) allow pharmacists to adjust medication regimens, avoid clinical inertia and improve patient outcomes3OBJECTIVE•  To determine the impact of pharmacist interventions on clinical outcomes (i.e., change in A1C) in adult patients with uncontrolled type 2 diabetes (DM2)METHODSCONCLUSIONS•  Physician-pharmacist CPAs improve clinical outcomes in adult patients with DM2   Increase physician face to face time with patients   Decrease non-billable physician time   Decrease time to therapeutic goals   Improve pay-for-performance quality metrics•  Limitations   Lack of clinician buy-in   Limited pharmacist FTE•  Future Directions   Continue to improve utilization of preferred medications   Streamline pharmacist workflow / improve efficiency    Expansion of pilot and future integration with other service linesRESULTSacknowledgementsGrant Greenberg MD, MA, MHSA, FAAFP; Kathleen Straubinger, MSN, RN, NE-BC; Elie Jabbour, PharmD, MBA Take a picture for more details6.57.07.58.08.59.09.510.010.5Baseline A1C Most Recent A1C9.57.2Change in A1C–Active01020304050607080■ Before Intervention    ■ After Intervention7470212713274417996411MET SULF DPP4 GLP-1 SGLT2 TZD MEGMedication UtilizationFigure 1. Change in A1C - Active. Includes all patients who met with a pharmacist > 1 time, had > 1 repeat A1C and were not lost to follow-up (n=26). Change in A1C 2.3%.Figure 2. Change in A1C - Enrolled. Includes all patients who met with a pharmacist > 1 time and had > 1 repeat A1C (n=53). Change in A1C 1.4%.Figure 3. Medication Utilization Before and After Intervention. Monitoring• Non-pregnant adult patients with uncontrolled DM2 taking at least one antidiabetic medication• Excluded if followed by endocrinology• Pharmacists modified antidiabetic medication regimens via a physician-pharmacist CPA, provided diabetes self-care education, assessed  barriers to medication adherence, and placed referrals to other care team members (i.e., social worker, dietician)• Follow-up visits every 1 to 12 weeks, as needed, for possible medication adjustments• Measured outcome: change in A1C from baselinePopulation Intervention6.57.07.58.08.59.09.510.010.5Baseline A1C Most Recent A1C9.78.3Change in A1C–Enrolledreferences1  Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2017.2  Okemah J, Peng J, Quiñones M. Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review. Adv Ther. 2018;35(11):1735–1745.3  Eric J. Ip, Bijal M. Shah, Junhua Yu, James Chan, Lynda T. Nguyen, Deempal. C. Bhatt. Enhancing diabetes care by adding a pharmacist to the primary care team. AJHP, 2013;70(10):877–886.

Working Together to Improve Outcomes: Physician-Pharmacist Collaborative Agreement for Uncontrolled Type 2 Diabetes

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Working Together to Improve Outcomes: Physician-Pharmacist Collaborative Agreement for Uncontrolled Type 2 Diabetes

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