(1072) Impact of Pharmacist-physician Collaboration on Diabetic Clinical Outcomes in Federally Qualified Health Centers

Objectives: Pharmacist inclusion into patient care teams in a variety of settings, including primary health care, has been shown in the literature to improve clinical outcomes for patients with chronic conditions when compared to standard of care. (1,2,3) For example, pharmacist-physician collaboration has a positive impact on glycemic control in patients with diabetes exposed to pharmacy services with achievement of glycemic control (A1C < 7) in a shorter median time compared to those receiving usual care. (2,3) This study is an example of pharmacist-physician collaboration within a federally qualified health center, where pharmacists provide individualized direct patient care utilizing a Collaborative Practice Agreement (CPA) to manage patients with chronic disease states, such as diabetes, upon referral.

This research aims to add to the current literature supporting pharmacist inclusion in patient care teams and provide insight into the impact that pharmacists can have on clinical outcomes associated with Uniform Data System (UDS) and Clinical Quality Measures (eCQM). The primary endpoint of the study is the mean absolute change from baseline hemoglobin A1C (HbA1C) to 3- or 6-months post-pharmacist engagement. The secondary endpoints include, completed pharmacist-led diabetes self-management interventions (education, lifestyle changes and medication adjustments) categorized and totaled, number of completed visits and revenue generated (in dollars) as well as medication adherence (proportion of days covered or PDC).

Methods: This institutional review board (IRB) approved multi-center matched cohort study that will include patients who have received care from the clinical pharmacy program at three federally qualified health centers from October 2021 to June 2023. The EPIC/OCHIN datasets will be divided into two cohorts based on the exposure to the pharmacist during the study period. The cohorts are: patients receiving care from a team consisting of a pharmacist and primary care provider compared to patients solely receiving care from a primary care provider. The cohorts will be matched 1:1 according to age (±5 years), gender, race/ethnicity, and baseline A1C. Inclusion criteria include: all non-pregnant patients ≥18 years-old, diagnosis of Type II diabetes, A1C ≥9%, and received care between October 2021 to June 2023.

For analysis, the research team will generate two EPIC/OCHIN datasets based on patients that were seen at least twice during the study period. Each data set will be coded to include patient demographics (race, ethnicity, age, gender, and insurance status), and primary and secondary outcomes as described above. The research team will perform a chart review to categorize and total the number of pharmacist interventions made. Statistical analysis for both primary and secondary outcomes includes an independent two-sample t-test based on the change in A1C pre/post-pharmacist engagement between the two cohorts and descriptive statistics for all secondary outcomes.

Results: N/A

Conclusions: N/A