According to results presented by researchers at AMCP 2023, risk stratification as part of chronic disease management (CDM) services provided by pharmacists is effective at controlling A1c in high-risk patients and maintaining control in lower risk patients. 

As part of a retrospective study, researchers categorized patients with A1c ≥10 as high risk and placed them in a group where they received high-touch clinical support from pharmacists. 

In collaboration with health care providers, pharmacists made therapy recommendations and documented interventions. When A1c levels dropped below 8, patients were categorized as low risk. 

To measure the adherence, side effects, and hospitalization, both risk level cohorts received medication delivery and check-in assessments. Results from both cohorts were compared to a patient cohort in which CDM pharmacy services were not utilized. 

Per the results, of 460 included patients in the CDM services cohort, 88 received high touch clinical support.
Of patients who received support, A1c levels were an average 11.47 with a most recent average of 8.84. A total of 63 patients were able to transition from high to low risk after an average 192 days. 

“The remaining 372 patients were stratified into the low-risk group with an average baseline A1c of 8.41,” said authors. “These patients had a most recent average A1c of 7.54, demonstrating a 0.87-point reduction.”

On average, patients utilizing pharmacist-provided CDM services demonstrated a 0.21 percentage point reduction in A1c. 

Of the 327 total regimen interventions enacted by pharmacists, 38% (123) were related to therapy change or dosage adjustment, followed by provider office visits, medication recommendations, and lab work. 

“This demonstrates the impact health system specialty pharmacies can have on chronic disease management and outlines a strategy to provide the greatest impact in a high-volume patient population,” concluded authors. 

Reference:
Mourani J, Stout M. Utilization of risk stratification in patients with diabetes mellitus in a health system specialty pharmacy setting. J Manag Care Spec Pharm. 2023;29(10-a suppl):S1-S137. https://www.jmcp.org/pb-assets/Poster%20Abstract%20Supplements/AMCP2023_PosterAbstractSupplement_0317-1679318682267.pdf