Evaluation of outcomes of a medication therapy management program for patients with diabetes

Objective To measure the impact of an employer-sponsored, pharmacist-provided medication therapy management (MTM) program on clinical outcomes and social and process measures for patients with diabetes with or without associated comorbid conditions. Methods Prospective longitudinal study that took place at seven independent pharmacies in Lucas County, OH. A total of 228 patients with diabetes were enrolled. At 6-month intervals, patients were counseled by their pharmacists. Outcome measures included clinical outcomes (glycosylated hemoglobin [A1C], systolic blood pressure (SBP), and diastolic blood pressure [DBP]), social measures (caffeine intake, alcohol consumption, smoking, and exercise), and process measures (visits to ophthalmologist, podiatrist, and dentist). Wilcoxon signed–rank test and percentages were used to report findings. Results Mean (±SD) A1C concentration decreased from 7.08 ± 1.54% to 6.89 ± 1.30% at 12 months. Patients with A1C levels greater than 7% at baseline averaged a decrease of 0.5% at 6 months and 0.75% at 12 months. Mean SBP values decreased significantly from baseline to 12 months. A total of 87 patients with a baseline SBP greater than 130mm Hg experienced a significant change in blood pressure from baseline to 6 months (−7.1 ± 3.32mm Hg), and 65 patients experienced a significant change in blood pressure from baseline to 12 months (−11.49 ± 0.15mm Hg). A total of 104 patients with a baseline DBP more than 80mm Hg experienced a significant decrease of 4.44 ± 1.25mm Hg at 6 months. Caffeine and alcohol consumption and smoking decreased and exercise increased. In addition, the percentage of patients who visited specialists increased. Conclusion Patients with diabetes experienced improvements in multiple clinical, social, and process measures.