2024 Eastern States Conference

TITLE: Evaluation of glycated hemoglobin in patients followed by a pharmacist and pharmacy liaison in an endocrinology clinic
AUTHORS: E Scurka, N Winters-Kelly, K Marti, DM O’Sullivan; Hartford Hospital, Hartford, Connecticut; The Hospital of Central Connecticut, New Britain, Connecticut
OBJECTIVE: The objective of this study is to evaluate whether patients in an endocrinology clinic who are followed by a pharmacist and a pharmacy liaison have greater HbA1c lowering compared to patients not followed by a pharmacist and pharmacy liaison.
METHODOLOGY: This single-center, retrospective study was conducted via chart review. Patient screening and selection was carried out using a patient list generated from prescription fill data that includes all patients who have been prescribed a GLP-1 receptor agonist, GIP/GLP-1 receptor agonist, and/or SGLT2 inhibitor. Records were categorized into one of two groups: “followed by a pharmacist and pharmacy liaison” or “not followed by a pharmacist and pharmacy liaison”. The primary outcome was the average reduction of HbA1c after 3 months between the two groups. Secondary outcomes included adherence rates for the “followed by pharmacist and pharmacy liaison group”, and an independent comparison of the average reduction of HbA1c at 6, 9, and 12 months, when applicable. All statistical analyses were completed with SPSS v. 29 (IBM; Armonk, NY 2022), using an a priori alpha level of 0.05 such that results yielding p<0.05 were considered statistically significant.
RESULTS: A total of 100 patients were included in each group of this study. The results showed that patients in the “followed by pharmacist and pharmacy liaison” group had a greater reduction in their HbA1c when compared to baseline at 3 months (mean change: 0.626 vs 0.006, p=0.022), 6 months (mean change: 0.972 vs 0.018, p=<0.001), 9 months (mean change: 1.338 vs 0.313, p=0.007), and 12 months (mean change: 0.863 vs -0.089, p=0.002) compared to those not followed. This study also found that patients in the “followed” group were considered to be adherent to their medications (mean adherence: 85.88%). Adherence was measured using the proportion of days covered (PDC) calculation, and was defined as PDC ≥80% by the Pharmacy Quality Alliance (PQA).
CONCLUSIONS: This study showed that having patients followed by a pharmacist and pharmacy liaison led to a greater reduction in HbA1c at 3 months and the reduction was maintained over 12 months compared to those who were not followed. These results support the benefit of having pharmacist involvement in outpatient specialty care, specifically endocrinology, and will help serve as a foundation to include pharmacists in other specialty clinics.