(1071) Impact of Pharmacist-led Continuous Glucose Monitoring Program on Reduction in a1c in an FQHC

Objectives: The primary objective of the study is to illustrate the benefit of a pharmacist-led CGM management program in a federally qualified health center. A secondary objective of the study is to assess the reduction of A1c from baseline in patients receiving diabetes management through a pharmacist-led continuous glucose monitor (CGM) management program relative to standard use of a CGM without pharmacist intervention.
The implementation of CGMs in patient care has allowed for more targeted and individualized diabetes management resulting in reduced A1c and increased patient empowerment in managing their diabetes without change in medications. Pharmacist-led management of professional CGM devices has proven benefit regarding patient outcomes; however, these devices are not meant for sustainable, long-term patient use. Research is lacking in the area of pharmacists managing diabetes using patient’s personal CGMs. As pharmacists continue to remain widely available, the role of pharmacists in the management of type 2 diabetes using continuous glucose monitoring should be expanded. The long-term goal of this study is to place emphasis on the clinical influence that pharmacists have on patients with diabetes and to increase the role of pharmacists in the management of diabetes through CGM use. This study aims to close the gap in data regarding the management of diabetes using personal CGMs in a pharmacist-led program in a federally qualified health center. Our central hypothesis is that pharmacist-led CGM management will lead to a larger A1c reduction in patients with type 2 diabetes than in patients using a CGM without pharmacist intervention.

Methods: This study is a retrospective, cohort analysis that will be completed at a federally qualified health center. Established patients receiving pharmacist-led care through Freestyle Libre or Dexcom report analysis will be included in the study. A collaborative practice agreement will be utilized to make medication adjustments and interventions based on the individualized CGM reports throughout the study. Patients will be identified using several platforms including the facility’s Dexcom dashboard and Freestyle Libre dashboard. Patients will also be identified using the facility’s electronic health record to identify patients scheduled for visits with the chief complaint listed as “Libre upload” or “Dexcom upload.” Inclusion criteria for the study include a diagnosis of type 2 diabetes, a baseline A1c within 2 months of initiating a CGM, continued use of Freestyle Libre or Dexcom for at least 6 months, A1c measured at 3- or 4-month intervals, and at least 1 pharmacist-led CGM upload appointment. Exclusion criteria for the study include a diagnosis of type 1 diabetes and patients with diabetes managed by an outside endocrinology office.
Data will be collected in a password protected Microsoft Excel spreadsheet. After patients are identified, chart review will be performed to collect data including the date of Freestyle Libre or Dexcom initiation and respective A1c values. The data to be collected in the study includes the patient’s last name, medical record number, date of CGM initiation, number of appointments scheduled for CGM upload, number of medication interventions made by the clinical pharmacist in the scheduled CGM upload appointments, date of baseline A1c, and A1c at baseline, and subsequent A1c values after initiation of pharmacist-led CGM management.
Data collection is currently in process and is expected to be complete by January 31, 2024. Data analysis is expected to be complete prior to March 1, 2024. A Wilcoxon Rank Sum Test is the statistical analysis that will be completed to determine the change in A1c over time in patients with pharmacist-led management of diabetes using CGMs. Descriptive statistics will be utilized to determine mean change in A1c over time.

Results: No results at this time.

Conclusions: No conclusion at this time.