(1070) Impact of Pharmacist Intervention on Achieving Goal Time in Range in the Primary Care Setting

Objectives: Diabetes is a common health condition affecting over 37 million persons in the United States. Current literature supports continuous glucose monitor (CGM) use for improving the quality of glycemic control and reducing the risk of hypoglycemia, with the Advanced Technologies & Treatments for Diabetes (ATTD) Congress first issuing consensus recommendations regarding CGM data and time in range (TIR) in 2019. The TIR metric, which represents the amount of time a patient’s glucose remains within a range of 70 to 180 mg/dL, can provide additional information about glycemic excursions, glucose variation, and episodes of hypoglycemia compared to the typical A1c measurement. Research is sparce on pharmacist-specific diabetes interventions utilizing CGM data; however, recent studies have shown that pharmacist implementation of CGM management leads to greater A1c reduction than physician-driven implementation, and that pharmacists using CGMs as part of diabetes management were able to increase the number of patients meeting A1c goals. No studies to date have looked specifically at pharmacist impact on TIR, which may provide a better picture of glycemic control. The primary objective of this study is to identify the proportion of patients with diabetes who received pharmacist intervention using a CGM that achieved goal TIR, defined as >70% of sensor readings between 70 to 180 mg/dL. Secondary objectives include (1) quantification of the number of pharmacy outreach attempts to achieve TIR, (2) comparison of the number of level one and level two hypoglycemic events at baseline and following pharmacist intervention, (3) evaluation of changes in glucose variability expressed as coefficient of variation (CV) following pharmacist intervention, and (4) identification of barriers to CGM use.

Methods: This study is being conducted in a network of seven internal medicine primary care clinics in which pharmacists utilize collaborative practice agreements (CPAs) in disease state management. When managing diabetes, pharmacists apply CGM data to adjust therapeutic regimens. This study is a retrospective chart review of data from July 2022 to July 2023. Patients with a diagnosis of Type I or Type II diabetes who engaged with pharmacy via the CPA and utilized a CGM with connection to a software platform are included in the study. Exclusion criteria includes an A1c ≤9% at time of referral to pharmacy, age < 18 years old, or CGM activity ≤70%. Collected data will be analyzed using inferential and descriptive statistics.

Results: Approximately 100 patients were identified for inclusion. Results for each objective are pending.

Conclusions: Research in progress.