Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost
Daniel D Maeng, Jove Graham, Michael Bogart, Jing Hao, Eric A Wright Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA Purpose: Pharmacist-led medication therapy disease management (MTDM) has shown improvement in clinical outcomes in patients with certain chronic...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-09-01
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| Series: | ClinicoEconomics and Outcomes Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/impact-of-a-pharmacist-led-diabetes-management-on-outcomes-utilization-peer-reviewed-article-CEOR |
| _version_ | 1819172677308383232 |
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| author | Maeng DD Graham J Bogart M Hao J Wright EA |
| author_facet | Maeng DD Graham J Bogart M Hao J Wright EA |
| author_sort | Maeng DD |
| collection | DOAJ |
| description | Daniel D Maeng, Jove Graham, Michael Bogart, Jing Hao, Eric A Wright Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA Purpose: Pharmacist-led medication therapy disease management (MTDM) has shown improvement in clinical outcomes in patients with certain chronic diseases. However, only limited data demonstrating the impact on health care utilization and cost of care are available. This study seeks to evaluate the impact of a pharmacist-led MTDM program on clinical surrogate outcomes, care utilization, and cost of care among patients with diabetes mellitus. Methods: A retrospective cohort study was conducted by utilizing electronic health records and insurance claims data. Patients were identified between February 2011 and December 2014. Data were collected from Geisinger, a large integrated health care system located in Pennsylvania and southern New Jersey. A total of 5,500 patients with diabetes mellitus were identified; 2,750 were enrolled in MTDM and were 1-to-1 propensity score-matched to a comparison cohort not enrolled in a pharmacist-led MTDM program. Results: There were no differences between groups in composite HbA1c, blood pressure, or low-density lipoprotein cholesterol goal attainment at 12 months (12% vs 12%, P=0.53). HbA1c goal was reached more frequently among patients without MTDM compared to those at 12 months (57% vs 51%, P<0.0001). There were no significant differences between the two cohorts in the attainment of blood pressure or low-density lipoprotein cholesterol goals at 12 months. MTDM was associated with reduced all-cause hospitalization rate (–19.6%; P=0.02) as well as increased primary care physician visits (18.5%; P<0.001) and lower average per-member-per-month medical cost (–13%, P=0.027). Conclusion: Despite the lack of impact on the clinical surrogate outcomes, MTDM was associated with lower cost of care and fewer hospitalizations, possibly facilitated by increased monitoring (ie, higher primary care utilization). Keywords: diabetes, pharmacist, medication therapy management, health outcomes, HbA1c, utilization, cost of care |
| first_indexed | 2024-12-22T20:10:59Z |
| format | Article |
| id | doaj.art-22d69d82feb9447095e0028d4b8f23db |
| institution | Directory Open Access Journal |
| issn | 1178-6981 |
| language | English |
| last_indexed | 2024-12-22T20:10:59Z |
| publishDate | 2018-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | ClinicoEconomics and Outcomes Research |
| spelling | doaj.art-22d69d82feb9447095e0028d4b8f23db2022-12-21T18:14:02ZengDove Medical PressClinicoEconomics and Outcomes Research1178-69812018-09-01Volume 1055156240826Impact of a pharmacist-led diabetes management on outcomes, utilization, and costMaeng DDGraham JBogart MHao JWright EADaniel D Maeng, Jove Graham, Michael Bogart, Jing Hao, Eric A Wright Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA Purpose: Pharmacist-led medication therapy disease management (MTDM) has shown improvement in clinical outcomes in patients with certain chronic diseases. However, only limited data demonstrating the impact on health care utilization and cost of care are available. This study seeks to evaluate the impact of a pharmacist-led MTDM program on clinical surrogate outcomes, care utilization, and cost of care among patients with diabetes mellitus. Methods: A retrospective cohort study was conducted by utilizing electronic health records and insurance claims data. Patients were identified between February 2011 and December 2014. Data were collected from Geisinger, a large integrated health care system located in Pennsylvania and southern New Jersey. A total of 5,500 patients with diabetes mellitus were identified; 2,750 were enrolled in MTDM and were 1-to-1 propensity score-matched to a comparison cohort not enrolled in a pharmacist-led MTDM program. Results: There were no differences between groups in composite HbA1c, blood pressure, or low-density lipoprotein cholesterol goal attainment at 12 months (12% vs 12%, P=0.53). HbA1c goal was reached more frequently among patients without MTDM compared to those at 12 months (57% vs 51%, P<0.0001). There were no significant differences between the two cohorts in the attainment of blood pressure or low-density lipoprotein cholesterol goals at 12 months. MTDM was associated with reduced all-cause hospitalization rate (–19.6%; P=0.02) as well as increased primary care physician visits (18.5%; P<0.001) and lower average per-member-per-month medical cost (–13%, P=0.027). Conclusion: Despite the lack of impact on the clinical surrogate outcomes, MTDM was associated with lower cost of care and fewer hospitalizations, possibly facilitated by increased monitoring (ie, higher primary care utilization). Keywords: diabetes, pharmacist, medication therapy management, health outcomes, HbA1c, utilization, cost of carehttps://www.dovepress.com/impact-of-a-pharmacist-led-diabetes-management-on-outcomes-utilization-peer-reviewed-article-CEORdiabetespharmacistmedication therapy managementhealth outcomesHemoglobin A1cutilizationcost of care |
| spellingShingle | Maeng DD Graham J Bogart M Hao J Wright EA Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost ClinicoEconomics and Outcomes Research diabetes pharmacist medication therapy management health outcomes Hemoglobin A1c utilization cost of care |
| title | Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost |
| title_full | Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost |
| title_fullStr | Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost |
| title_full_unstemmed | Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost |
| title_short | Impact of a pharmacist-led diabetes management on outcomes, utilization, and cost |
| title_sort | impact of a pharmacist led diabetes management on outcomes utilization and cost |
| topic | diabetes pharmacist medication therapy management health outcomes Hemoglobin A1c utilization cost of care |
| url | https://www.dovepress.com/impact-of-a-pharmacist-led-diabetes-management-on-outcomes-utilization-peer-reviewed-article-CEOR |
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