Project IMPACT: Diabetes shows value of pharmacist patient care services

Pharmacists delivering patient care services as part of patient-centered, interdisciplinary healthcare teams can make a difference for diabetes patients who are disproportionately affected by the disease and have limited access to quality care, according to the final results of Project IMPACT: Diabetes.

This national research initiative, developed and supported by the American Pharmacists Association (APhA) Foundation, demonstrated that pharmacists working in communities across the United States as part of teams of providers can help improve clinical outcomes in adult diabetes patients who are faced with barriers to care, such as lack of or limited insurance, homelessness, and/or living in poverty.

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In two reports published in the September/October Journal of the American Pharmacists Association, Benjamin Bluml, BS Pharm, and his co-authors summarized the clinical outcomes and tactics used for implementing the diabetes initiative. They found that a population of more than 1,800 diabetes patients from 25 communities in 17 states was able to achieve a statistically significant and clinically relevant decline in mean glycosylated hemoglobin (A1C) levels (-0.8%) over a one-year period. Other progress was seen in decreases of systolic and diastolic blood pressure levels, low-density lipoprotein cholesterol, triglycerides, and total cholesterol, but the results were not clinically relevant, the authors noted.

During the one-year time frame, patients met with their pharmacists approximately five times, spending an average of nearly 40 minutes per visit, for a total of about 200 minutes. During the visits, pharmacists worked with diabetes patients to manage their disease using the APhA Foundation’s Patient Self-Management Program. Various practice innovations were employed, such as collaborative practice agreements, group education classes, and joint provider visits. Nineteen community programs provided incentives to enrolled patients, including discounted copays for medications or diabetes supplies, free or discounted diabetes test strips, gift cards, transportation vouchers, and additional health services-like eye examinations.

“Project IMPACT: Diabetes is the first comprehensive, practice-based research initiative to demonstrate that pharmacists working in community-based diabetes care teams can significantly reduce A1C levels and other clinical markers of diabetes for patients of various economic, social, and insurance statuses in diverse communities across the United States,” wrote Bluml, vice president for research and innovation at the APhA Foundation, and his colleagues.

There were some limitations of the study, the authors noted, such as lack of clinical relevance of the change in non-A1C diabetes indicators, variability of the practice models and delivery of care from the 25 communities, and barriers to care, such as transience and poverty challenges. In the future, help with transportation and other incentives should be considered for populations faced with similar challenges.