(1299) Expanding Pharmacy Access for Continuous Glucose Monitoring Services in a Predominantly Hispanic Patient Population with Diabetes

Objectives: The overall goal of this project innovation is to pilot a continuous glucose monitoring (CGM) service based in a community pharmacy at a federally qualified health center (FQHC) for patients living with diabetes. These patients with diabetes are predominantly Hispanic and medically underserved from lower socioeconomic communities in a metropolitan city on the United States-Mexico border.
The primary objectives of the pilot project are to: (1) create infrastructure to support CGM services within a community pharmacy setting, (2) educate and train a community pharmacy team on the use of CGM technology, and (3) recruit and expand CGM services to patients living with diabetes who have poor glycemic control.
The community pharmacy team recognizes the opportunity to enhance CGM services at the pharmacy counseling window. According to the 2023 American Diabetes Association Standards of Care for Diabetes (ADA) guidelines, it is recommended to implement continuous glucose monitoring (CGM) on patients using subcutaneous insulin or multiple daily injections for diabetes with poor glycemic control.

Methods: To implement this pilot CGM project at the pharmacy counseling window, the pharmacy resident will create an infrastructure to support the services by (1) establishing billing parameters, (2) developing a protocol and workflow for CGM placement, (3) adding CGM sensors to inventory, and (4) creating encounter documentation for electronic health records. To support skill development, the resident will conduct workshops to educate the community pharmacy team on CGM. Topics for workshops will pertain to key CGM technology nomenclature, demonstrating proper placement, setting the patient portal, and interpreting the glucose readings collected. To recruit for CGM, as patients drop off prescriptions the pharmacists and technicians will identify patients on multiple injectable diabetes medications, on high dose insulin, and with uncontrolled glycemic levels. The team will evaluate appropriateness for CGM with provider approval or under protocol. Recruited patients will receive the initial CGM sensor placement at the pharmacy counseling window and follow up for a new sensor placement every two weeks. The resident will adapt educational material in Spanish and English appropriate to the health literacy of the population. To ensure adequate recruitment of patients, the resident will document the number of patients receiving initial sensor placement and follow-up appointments to meet the goal of 25 patients enrolled using a convenience sample over six months (October 2023 – April 2024). The resident will analyze the project innovation by documenting project outcomes, infrastructure developed, type of educational content provided to the pharmacy team, and number of patients recruited for CGM placement follow up.

Results: N/A

Conclusions: N/A