Specialty Pharmacy ContinuumPharmacist-Managed Diabetes Program Slashes HbA1c Levels

A pharmacist-managed diabetes care program demonstrated substantial clinical outcomes, reducing mean HbA1c from 9.4% to 6.7% at graduation. The collaborative practice agreement model addressed primary care provider shortages while achieving sustained glycemic control in 64.6% of participants within one year.

⚕️ Key Clinical Considerations ⚕️

• Statistical Significance: Average HbA1c reduction of 2.68% in graduates translates to 14% decreased MI risk, 16% reduced HF risk, and 12% lower stroke risk per 1% HbA1c improvement
• Medication Optimization: Sulfonylurea use decreased 50% (9 to 4 patients), reducing hypoglycemia risk while increasing cardioprotective agents like GLP-1 agonists and SGLT2 inhibitors
• Durability Assessment: Over 60% of graduates maintained HbA1c goals at follow-up versus 15% of non-graduates, demonstrating sustained therapeutic benefit
• Health Disparities: Lower graduation rates observed in Spanish-speaking patients (52.5% vs 76.5%) and Hispanic/Latino populations (51.2% vs 80.6%), indicating need for targeted interventions
• Evidence Quality: Single-center retrospective analysis limits generalizability but provides real-world effectiveness data for collaborative pharmacy practice models

🎯 Clinical Practice Impact 🎯

• Patient Communication: Emphasize pharmacist accessibility and diabetes self-management education to improve patient engagement and medication adherence.
• Practice Integration: Implement collaborative practice agreements with primary care to expand diabetes management capacity and optimize therapeutic outcomes.
• Risk Management: Focus on hypoglycemia prevention through sulfonylurea deprescribing and patient education on proper injection techniques for GLP-1 agonists.
• Action Items: Develop Spanish-language medication labeling, establish delivery services for transportation-limited patients, and create systematic HbA1c goal maintenance protocols.

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