دورية أكاديمية
An Effectiveness Evaluation of a Primary Care-Embedded Clinical Pharmacist-Led Intervention Among Blacks with Diabetes.
العنوان: | An Effectiveness Evaluation of a Primary Care-Embedded Clinical Pharmacist-Led Intervention Among Blacks with Diabetes. |
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المؤلفون: | Narain KDC; Department of Medicine, Division of General Internal Medicine and Health Services Research (GIM/HSR), University of California, Los Angeles, Los Angeles, CA, 90024, USA. KNarain@mednet.ucla.edu.; Center for Health Advancement, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA. KNarain@mednet.ucla.edu., Doppee D; Department of Medicine, Division of General Internal Medicine and Health Services Research (GIM/HSR), University of California, Los Angeles, Los Angeles, CA, 90024, USA., Li N; Department of Medicine, Division of General Internal Medicine and Health Services Research (GIM/HSR), University of California, Los Angeles, Los Angeles, CA, 90024, USA., Moreno G; Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA., Bell DS; Department of Medicine, Division of General Internal Medicine and Health Services Research (GIM/HSR), University of California, Los Angeles, Los Angeles, CA, 90024, USA.; Clinical and Translational Science Institute, University of California, Los Angeles, Los Angeles, CA, USA., Do AL; Clinical and Translational Science Institute, University of California, Los Angeles, Los Angeles, CA, USA., Follett RW; Clinical and Translational Science Institute, University of California, Los Angeles, Los Angeles, CA, USA., Mangione CM; Department of Medicine, Division of General Internal Medicine and Health Services Research (GIM/HSR), University of California, Los Angeles, Los Angeles, CA, 90024, USA.; Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA. |
المصدر: | Journal of general internal medicine [J Gen Intern Med] 2020 Sep; Vol. 35 (9), pp. 2569-2575. Date of Electronic Publication: 2020 Mar 06. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 8605834 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1497 (Electronic) Linking ISSN: 08848734 NLM ISO Abbreviation: J Gen Intern Med Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Secaucus, NJ : Springer Original Publication: [Philadelphia, PA] : Hanley & Belfus, [c1986- |
مواضيع طبية MeSH: | Diabetes Mellitus, Type 2*/drug therapy , Pharmacists*, Black or African American ; Humans ; Medication Adherence ; Primary Health Care |
مستخلص: | Background: Black individuals with type 2 diabetes suffer disproportionate morbidity and mortality relative to whites with type 2 diabetes, irrespective of health insurance coverage. Objective: Examine the impact of a primary care-embedded clinical pharmacist-led intervention (UCMyRx) on cardiovascular risk factor control among blacks with type 2 diabetes in a large healthcare system. Design: We used data extracted from the electronic health records (EHR) system and a difference-in-differences study design with a propensity-matched comparison group to evaluate the impact of UCMyRx on HbA1c and systolic blood pressure (SBP) among black patients with type 2 diabetes, relative to usual care. Participants: Individuals with type 2 diabetes identified as either black or African American in the EHR that were ≥ 18 years of age that had the following observations during the study window (03/02/2013-12/31/18: (1) HbA1C ≥ 8%, at least once, anywhere between 365 days before and 14 days after the UCMyRx visit and a follow-up HbA1c measure within 120 to 365 days after the visit and/or (2) SBP ≥ 140 mmHg at least once between 365 days before and 14 days after the UCMyRx visit that had a follow-up SBP measure within 120 to 450 days after the visit. Intervention: UCMyRx pharmacists review labs and vital signs, perform medication reconciliation, use a standardized survey to assess barriers to medication adherence, and develop tailored interventions to improve medication adherence. Main Measures: Change in HbA1c and change in SBP from before to after the first UCMyRx visit. Key Results: Having at least one visit with a UCMyRx clinical pharmacist was associated with a significant reduction in HbA1c (- 0.4%, p value = .01); however, there was no significant impact on SBP (- .051 mmHg, p value = 0.74). Conclusions: The UCMyRx intervention is a useful strategy for improving HbA1c control among blacks with type 2 diabetes. |
References: | Med Care Res Rev. 2007 Oct;64(5 Suppl):101S-56S. (PMID: 17881626) J Racial Ethn Health Disparities. 2018 Feb;5(1):7-14. (PMID: 28078660) Health Serv Outcomes Res Methodol. 2014 Dec 1;14(4):166-182. (PMID: 25530705) Diabetes Care. 2017 Apr;40(4):440-443. (PMID: 28325794) Ann Pharmacother. 1996 Mar;30(3):238-43. (PMID: 8833557) Am J Prev Med. 2015 Jun;48(6):747-54. (PMID: 25998925) Curr Med Res Opin. 2004 Aug;20 Suppl 1:S5-26. (PMID: 15324513) Stat Sci. 2010 Feb 1;25(1):1-21. (PMID: 20871802) J Diabetes Complications. 2013 Jan-Feb;27(1):34-40. (PMID: 23062328) Clin Transl Gastroenterol. 2014 Jan 02;5:e45. (PMID: 24384867) J Health Commun. 2011;16 Suppl 3:268-78. (PMID: 21951257) Diabetes Care. 2018 May;41(5):917-928. (PMID: 29567642) Clin Ther. 2014 Dec 1;36(12):1991-2002. (PMID: 25282579) Am J Med. 2005 Mar;118(3):276-84. (PMID: 15745726) Diabetes Care. 2009 Dec;32(12):2143-8. (PMID: 19729527) J Am Geriatr Soc. 2015 May;63(5):893-901. (PMID: 25955280) Pharmacotherapy. 2005 May;25(5):676-84. (PMID: 15899729) BMC Health Serv Res. 2009 Feb 07;9:24. (PMID: 19200387) World J Diabetes. 2014 Dec 15;5(6):945-50. (PMID: 25512801) Am J Geriatr Pharmacother. 2010 Apr;8(2):136-45. (PMID: 20439063) Diabet Med. 2016 Nov;33(11):1575-1581. (PMID: 26773733) Appl Health Econ Health Policy. 2016 Aug;14(4):419-429. (PMID: 27371369) Diabetes Technol Ther. 2007 Jun;9(3):203-10. (PMID: 17561790) |
معلومات مُعتمدة: | K23 AG042961 United States AG NIA NIH HHS; P30 AG021684 United States AG NIA NIH HHS; UL1TR001881 United States NH NIH HHS; P30AG021684 United States NH NIH HHS; UL1 TR001881 United States TR NCATS NIH HHS |
فهرسة مساهمة: | Keywords: diabetes; intervention; pharmacist; “medication adherence”; “quality of care”; “racial disparities” |
تواريخ الأحداث: | Date Created: 20200308 Date Completed: 20210514 Latest Revision: 20221207 |
رمز التحديث: | 20231215 |
مُعرف محوري في PubMed: | PMC7458955 |
DOI: | 10.1007/s11606-020-05750-0 |
PMID: | 32144694 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1525-1497 |
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DOI: | 10.1007/s11606-020-05750-0 |