Search

Objectives Pharmacist-led diabetes collaborative drug therapy management ( CDTM) has been shown to improve outcomes. Whether such programmes are effective specifically in Medicaid patients, who face barriers to access and self-management, has not been well characterized. This pilot study explores glycaemic control, utilization and costs associated with pharmacist-led CDTM in a small population of Medicaid patients with type 2 diabetes mellitus (T2 DM). Methods A pre-post, historical cohort study was conducted of patients with T2 DM and Medicaid coverage who received pharmacist-led CDTM in community-based primary care clinics between 2008 and 2012. Outcomes included change in haemoglobin A1c (HbA1c), healthcare costs and utilization. Results This study included 79 Medicaid patients with T2 DM who received pharmacist-led CDTM. A subset of 46 patients with Medicaid coverage through an affiliated Medicaid Plan, Healthy U, was identified for additional analysis. At 6-month follow-up, HbA1c was a mean ( SD) of 2.0% (2.0) lower than the baseline of 10.3% (1.7). Primary care clinic encounters increased by a mean (median) of 3.4 (2) visits. Per patient health system charges increased by a mean (median) of $4392 ($620), and the amount paid by Medicaid in the Healthy U subset was $822 ($68) higher in the follow-up period. Conclusion A pharmacist-led diabetes CDTM intervention was associated with improved glycaemic control in Medicaid patients, which corresponded with a higher number of primary care visits and observed costs. These findings are consistent with studies not limited to Medicaid, suggesting that CDTM can be effective in type 2 diabetes patients with Medicaid coverage. [ABSTRACT FROM AUTHOR]