Pharmacist-Led Interventions With CGM Shows Substantial Decrease in A1C
Clinical pharmacists counsel patients during the intervention and make informed medication changes based on the data received from continuous glucose monitoring (CGM).
According to the International Diabetes Federation, 1 in 8 adults will have diabetes by 2045, which is a 46% increase. Approximately 90% of patients have type 2 diabetes, which the federation states is driven by socioeconomic, demographic, environmental, and genetic factors, such as urbanization, ageing population, decreasing levels of physical activity, and increasing overweight and obesity prevalence.1
Clinical pharmacists counsel patients during the intervention and make informed medication changes based on the data received from continuous glucose monitoring (CGM). | Image Credit: Halfpoint - stock.adobe.com
However, in a study published in JAPhA Practice Innovations, pharmacist-led continuous glucose monitoring (CGM) programs can have a positive impact on health outcomes, such as reductions in A1c.2
“There is data that shows how much it helps patients with diabetes to improve their quality of life, as well as the management of their diabetes,” Lindsey Miller, PharmD, clinical assistant professor of pharmacy practice at the University of Mississippi, said in an interview at the American Pharmacists Association Annual Meeting and Expo 2025.3 “No matter what practice setting you're in, you probably encounter some patients with diabetes, and so whether it be through recommending to providers to get them on CGM devices, just to help them be empowered to make decisions throughout their day when it comes to what they're eating and what they're doing.”
Investigators in the current study aimed to determine the effectiveness of a clinical pharmacist’s intervention on diabetes management using a personal CGM. The primary end point included the effects of the program in a federally qualified health center, and the secondary objective was to assess the reduction in A1c overtime with the intervention compared with the use of a CGM alone.2
Patients were referred to the pharmacist-led CGM program by a provider referral and underwent an initial 1-hour, 1-1 appointment with a clinical pharmacist. The appointment reviewed the goals of therapy, the patient-specific goals, affordability, dosages, and more. At the conclusion of the first appointment, a 30-minute follow-up was scheduled, which included a review of the goals, medication, doses, diet modifications, and exercise. The details of the CGM report are also reviewed, including glucose management indicator, times in range, and trends. The clinical pharmacists also counsel the patient and make informed medication changes based on the data.2
Investigators found a significant change in median A1c with pharmacist-led CGM management from baseline to 3, 6, 9, and 12 months. Furthermore, the maximum number of medication interventions over 12 months was 18 for 1 patient, and there were 7 patients who did not receive any medication interventions by the pharmacist. At baseline, the median A1c was 8.7, decreasing to 7.5 at 3 months, 7.4 at 6 months, 7.5 at 9 months, and 2.7 at 12 months. Furthermore, the study authors reported that the mean A1c reduction due to pharmacist intervention compared without intervention was 0.8, and the point reduction was 50% higher for months 3 and 6 and 100% higher at 9 months to 12 months for patients in the pharmacist-led program compared to the use of CGMs alone.2
“There have been a lot of studies that have been published that I think are helping to tell the story of the value of CGMs, either in cost savings, because we always like to look at a financial outcome, but also looking at the quality measures that we see with patients in their A1c reduction and their quality of life too,” Miller said.3 “[Patients are] just feeling so much more involved and empowered to make those decisions throughout their day-to-day, and then I think in the long term, on more the health care metric side of things, we see that in their A1c reduction.”
READ MORE: Continuous Glucose Monitoring Resource Center
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