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J Int Med Res ; 46(1): 234-248, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28789606

RESUMEN

Objective Embedding clinical pharmacists into ambulatory care settings needs to be assessed in the context of established medical home models. Methods A retrospective, observational study examined the effectiveness of the Intermountain Healthcare Collaborative Pharmacist Support Services (CPSS) program from 2012-2015 among adult patients diagnosed with diabetes mellitus (DM) and/or high blood pressure (HBP). Patients who attended this program were considered the intervention (CPSS) cohort. These patients were matched using propensity scores with a reference group (no-CPSS cohort) to determine the effect of achieving disease management goals and time to achievement. Results A total of 17,684 patients had an in-person office visit with their provider and 359 received CPSS (the matched no-CPSS cohort included 999 patients). CPSS patients were 93% more likely to achieve a blood pressure goal < 140/90 mmHg, 57% more likely to achieve HbA1c values < 8%, and 87% more likely to achieve both disease management goals compared with the reference group. Time to goal achievement demonstrated increasing separation between the study cohorts across the entire study period ( P < .001), and specifically, at 180 days post-intervention (HBP: 48% vs 27% P < .001 and DM: 39% vs 30%, P < .05). Conclusions CPSS participation is associated with significant improvement in achievement of disease management goals, time to achievement, and increased ambulatory encounters compared with the matched no-CPSS cohort.


Asunto(s)
Atención Ambulatoria/organización & administración , Atención Dirigida al Paciente/organización & administración , Servicios Farmacéuticos/organización & administración , Farmacéuticos/organización & administración , Anciano , Antihipertensivos/uso terapéutico , Biomarcadores/sangre , Diabetes Mellitus/dietoterapia , Diabetes Mellitus/fisiopatología , Manejo de la Enfermedad , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Recursos Humanos
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